• Ulus Travma Acil Cerrahi Derg · Nov 2024

    Computed tomography and clinical outcomes in the diagnosis of acute appendicitis: Significance of periappendiceal fat tissue.

    • Mehmet Eşref Ulutaş, Abdullah Enes Ataş, Abdullah Sami Maden, İsmail Hasırcı, and Abdullah Hilmi Yılmaz.
    • Department of General Surgery, University of Health Sciences, Gaziantep City Hospital, Gaziantep-Türkiye.
    • Ulus Travma Acil Cerrahi Derg. 2024 Nov 1; 30 (11): 786794786-794.

    BackgroundThis study aimed to elucidate the diagnostic significance of changes in periappendiceal fat density observed on computed tomography (CT) in patients with acute appendicitis (AA).MethodsPatients who underwent surgery with a diagnosis of AA based on CT findings from January 1, 2020 to December 31, 2020 were included in the study. Patients were divided into three grades. In Grade 1, the periappendiceal tissue appears hypoechoic, indicative of normal tissue. In Grade 2, the periappendiceal tissue is slightly hyperechoic but confined to the periappendiceal area. In Grade 3, dense hyperechoic areas are present not only in the periappendiceal tissue but also extend into surrounding organs and deeper tissues. The groups were compared in terms of clinical, laboratory, and pathological outcomes.ResultsA total of 195 patients-131 males and 64 females-were included in the study. A correlation was identified between grade and several factors: appendix diameter, appendix wall thickness, incidence of lymphadenopathy, and duration of symptoms onset (p<0.001). Conditions such as appendicolitis, free air, and intra-abdominal abscesses were more frequently observed in Grade 3 patients compared to Grade 1 and Grade 2 patients (p=0.002, p<0.001). Both operative time and length of hospital stay were highest in Grade 3 patients (p<0.001). The rate of patients found to have a normal appendix upon pathological examination was significantly higher in Grade 1 than in Grade 2 (p=0.03).ConclusionIn cases where the diagnosis is uncertain, the hyperechogenicity in periappendiceal tissue observed on CT strengthens the diagnosis of AA. Additionally, cases of AA become increasingly complex as echogenicity in periappendiceal tissue increases.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…