Surgeons Best and Fastest at Diagnosing Appendicitis

A study has found that surgeons, not ultrasound or computed tomography (CT), are the most accurate in diagnosing appendicitis and do it more quickly than imaging scans. Conducted by researchers at the University of California Davis School of Medicine (USA; www.ucdmc.ucdavis.edu), the study was published in the May 2001 issue of Archives of Surgery.

The researchers reviewed the medical charts of 766 patients with suspected acute appendicitis who had undergone an appendectomy. They found that ultrasound was 43.4% accurate at diagnosing appendicitis, CT was 74.5% accurate, while a doctor's exam was 74.9%. Moreover, patients had appendectomies within 10 hours when the diagnosis was made by a surgeon, in 13 hours when it was made by ultrasound, and 19 hours when a CT scan was performed.

Over the past 10 years, studies have suggested that CT and ultrasound might lower the number of unnecessary appendectomies. As a result, emergency department doctors began ordering imaging tests before calling for a surgical consultation, thereby delaying needed appendectomies where speed could be a critical factor.

"Neither CT nor ultrasound improves the diagnostic accuracy rate,” said Hung Ho, associate professor of gastrointestinal and laparoscopic surgery at UC Davis and senior author of the study.




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