|Case 10 :|
40-year-old male presents with acute pain in the lower abdomen. Pain
subsides after 3 hours or so. USG of abdomen and pelvis is normal. CT is
What is the diagnosis?
__________SCROLL FOR ANSWER__________
There is strong evidence that
imaging with ultrasound and CT can be of substantial diagnostic value in
the diagnosis of acute appendicitis.
CT has become the primary imaging tool for patients suspected to have acute appendicitis. CT displays more accuracy as compared to USG in detecting acute appendicitis, as well as perforation. The percentage of negative appendectomy can be significantly reduced by USG & CT imaging. The standard protocol in imaging acute appendicitis is as follows: if ultrasound can pick up acute appendicitis, CT imaging in the patient can be avoided (although the detection of appendicular perforation is significantly higher with CT compared to USG), but if the USG is negative for acute appendicitis and cannot detect any other abnormal pathology as a cause of acute abdomen, CT should follow. Value of thinner slices (5 mm compared to 10 mm) also improves the diagnosis of acute appendicitis.