The role of non-enhanced computed tomography scan in the management of acute right lower quadrant pain

Abstract EN

Objective: To evaluate the efficacy of non-enhanced helical computed tomography scan in patients with acute right lower quadrant pain and diagnosing acute appendicitis. Method: A total number of 70 patients presented with right lower quadrant pain, suspected to have appendicitis were referred by emergency and surgical departments for a non-enhanced helical computed tomography scan.

The primary computed tomography criteria for diagnosing acute appendicitis were a distended appendix greater than 6 mm in maximal diameter, appendiceal wall thickening, and free peritoneal fluid.

Prospective diagnoses based on computed tomography findings were compared with surgical results and clinical follow-up. Results: Acute appendicitis was diagnosed in 30 of the 70 patients (43%).

Of the 30 patients with a computed tomography diagnosis of acute appendicitis, 27 (39%) had acute appendicitis proven by surgery and pathology.

Twenty-two (31%) patients had a normal computed tomography study and 18 (26%) patients had non-appendiceal pathologies.

There were 27 true-positives, 38 true negatives, 3 false positives, and 2 false negatives.

Non-contrast helical computed tomography had a sensitivity of 90%>, specificity of 95%, and accuracy of 95%>. Conclusion: This study shows that non-enhanced Computed tomography is a useful test to diagnose appendicitis in patients with acute abdominal pain in the right lower quadrant