CT usage linked to negative appendectomies

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Even when there is no hard pathologic evidence of appendicitis, a new report concludes that many patients undergo appendectomies due to a number of factors, including low use of CT scans, Reuters Health reports.
Of all of the appendectomies that are performed 15 percent of the procedures are considered negative appendectomies – ones that did not need to be performed, according to other studies sited by the study authors.
For the new study, researchers from the Taipei Veterans General Hospital in Taiwan evaluated 430 patients who had the procedure emergently because of suspected appendicitis.
The rate of negative appendectomy was 15.8 percent and most often occurred when a patient was female gender, anxiety or depression was reported, or if health-related quality of life issues existed. Other factors included lower white cell count, and lower CT scan usage.
As well as evaluating other factors, a “CT scan should be considered in patients suspected of having appendicitis, particularly in those with IBS and atypical clinical presentations," one of the researchers stated.
The current study "emphasizes that some unnecessary appendectomies might be prevented by a proper general approach, including documenting atypical history and examination findings, anxiety, a normal neutrophil count and obtaining CT when needed to confirm appendicitis," said Dr. George F. Longstreth, from Kaiser Permanente Medical Center in San Diego, California, in a related editorial, Reuters Health reports.
The complete study is published in the May issue of the journal Gut.