HYPOTHESIS: Relative merits and indications exist for ultrasonography (US) and computed tomography (CT) in the diagnosis of @entity698 . DESIGN: Prospective study. SETTING: General community and tertiary care hospital. METHODS: Ninety-nine @entity1 (50 males and 49 females) were studied. Following consent, the initial disposition was recorded, designating the @entity1 for operation, observation, or discharge from the hospital. Each @entity1 was studied by CT and US. Studies were independently evaluated by 2 radiologists, and the results were designated as positive, negative, or equivocal. The surgeon reevaluated @entity1 before and after learning the results of US and CT, recording whether the CT scan, US, or reexamination influenced the final disposition. RESULTS: Fifty @entity1 had @entity698 ; 6 appendixes were perforated. The initial clinical impression called for 44 operations, 49 observations, and 6 discharges. Thirty-four @entity1 had their treatment plan changed from the initial disposition. Ultrasonography did not affect the initial impression. In contrast, 18 @entity1 were rediagnosed solely on CT scan findings. Seven @entity1 were rediagnosed by reexamination. Of 44 @entity1 initially designated for operation, the CT scan and reexamination spared 6 females from surgery; the negative appendectomy rate potentially decreased from 50% to 17% (P =.03). The CT scan, US, or reexamination failed to spare 2 males from exploration with negative results. Of the 49 @entity1 initially designated for observation, 23 were rediagnosed after reevaluation, 13 were discharged from the hospital, and 10 underwent expedient operation. One @entity1 was spared from inappropriate discharge from the hospital. The reliability of the CT scan was good, with high sensitivities and specificities. Equivocal scan results lowered the diagnostic value. CONCLUSIONS: Selective use of a CT scan with a second examination can improve the diagnostic accuracy and management of suspected cases of @entity698 by (a) reducing the negative appendectomy rate in females, (b) moving @entity1 from observation to earlier operation or discharge from the hospital, and (c) preventing inappropriate discharge of @entity1 with @entity698 .

Computed tomography and ultrasonography in the diagnosis of XXXX : when are they indicated?

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity698 :: ('MESH:D001064', 'Disease') :: ['appendicitis']
@entity698 :: (MESH:D001064,Disease) :: ['appendicitis']
