Abstract
Fifty-three patients with 38 cases of perforated appendicitis and 15 cases of appendicitis
without perforation were evaluated based on the computed tomography (CT) appearances
of appendiceal diameter, phlegmon, abscess, extraluminal air, appendiceal wall enhancement,
lateroconal fascial thickening, appendicolith, bowel wall thickening, ascites, ileal
wall enhancement, peritoneal enhancement, periappendiceal fluid, omental haziness,
retrocecal appendix, intraluminal air, and the combination of intraluminal air and
appendicolith. The result of appendiceal diameter was compared using two-sample Student's
t test, and the other CT findings were analyzed by Fisher's Exact Test. Our results
showed that appendix was larger in caliber in perforated appendix (P<.05). Direct CT signs (i.e., phlegmon, abscess, and extraluminal air) were more specific
for perforated appendicitis (P<.05). Indirect signs (bowel wall thickening, ascites, ileal wall enhancement, intraluminal
air, and combined intraluminal air and appendicolith) were also found in higher incidence
in appendiceal perforation (P<.05). Appendiceal enlargement and ileal wall enhancement were the two predominant
findings in one case of perforation. We concluded that direct and indirect CT appearances
can differentiate appendicitis with and without perforation. Indirect signs may be
helpful in difficult case.
Keywords
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Article info
Publication history
Published online: September 13, 2004
Received:
July 3,
2003
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
