Imaging of Acute Appendicitis in Adults and Children PDF
Preview Imaging of Acute Appendicitis in Adults and Children
Medical Radiology Diagnostic Imaging Series Editors Albert L. Baert Maximilian F. Reiser Hedvig Hricak Michael Knauth Editorial Board Andy Adam, London Fred Avni, Brussels Richard L. Baron, Chicago Carlo Bartolozzi, Pisa George S. Bisset, Durham A. Mark Davies, Birmingham William P. Dillon, San Francisco D. David Dershaw, New York Sam Sanjiv Gambhir, Stanford Nicolas Grenier, Bordeaux Gertraud Heinz-Peer, Vienna Robert Hermans, Leuven Hans-Ulrich Kauczor, Heidelberg Theresa McLoud, Boston Konstantin Nikolaou, Munich Caroline Reinhold, Montreal Donald Resnick, San Diego Rüdiger Schulz-Wendtland, Erlangen Stephen Solomon, New York Richard D. White, Columbus For furthervolumes: http://www.springer.com/series/4354 Caroline Keyzer Pierre Alain Gevenois • Editors Imaging of Acute Appendicitis in Adults and Children 123 Editors Caroline KeyzerM.D.,Ph.D. PierreAlainGevenois M.D.,Ph.D. Department of Radiology Department ofRadiology Hôpital Erasme,Université librede HôpitalErasme, Université librede Bruxelles Bruxelles Route deLennik 808 Routede Lennik808 1070Brussels 1070Brussels Belgium Belgium e-mail: [email protected] e-mail:[email protected] ISSN 0942-5373 ISBN 978-3-642-17871-9 e-ISBN978-3-642-17872-6 DOI 10.1007/978-3-642-17872-6 SpringerHeidelbergDordrechtLondonNewYork LibraryofCongressControlNumber: 2011935930 (cid:2)Springer-VerlagBerlinHeidelberg2011 Thisworkissubjecttocopyright.Allrightsarereserved,whetherthewholeorpartofthematerialis concerned,specificallytherightsoftranslation,reprinting,reuseofillustrations,recitation,broadcasting, reproductiononmicrofilmorinanyotherway,andstorageindatabanks.Duplicationofthispublication orpartsthereofispermittedonlyundertheprovisionsoftheGermanCopyrightLawofSeptember9, 1965,initscurrentversion,andpermissionforusemustalwaysbeobtainedfromSpringer.Violationsare liabletoprosecutionundertheGermanCopyrightLaw. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protectivelawsandregulationsandthereforefreeforgeneraluse. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consultingtherelevantliterature. Coverdesign:eStudioCalamar,Berlin/Figueres Printedonacid-freepaper SpringerispartofSpringerScience+BusinessMedia(www.springer.com) Preface The appendix is considered as a vestigial organ, with no known physiological role, that has been accepted as the origin of a potentially life threatening but easily treatable inflammatory disease of the right lower quadrant of the abdo- men only at the end of the nineteenth century. Appendectomy for acute appendicitisissincethenstillthemostfrequentlyperformedemergencysurgical procedure. Despite the fact that this surgical procedure is so frequently and easily performed, its indication was, till recently, the result of equilibrium between the negative appendectomy rate and the appendiceal perforation rate. It has been advocated that imaging could play an important role in ruling out acute appendicitis, preventing negative appendectomy and in confirming acute appendicitis. Nevertheless, even if various diagnostic imaging techniques, especially ultrasonography (US) and computed tomography (CT), are widely availableanddiagnosticfeaturesverywellknownineachtechnique,theimpact of medical imaging on the clinical work-up of patients suspected of acute appendicitis remains a matter of debate. In addition, among the radiology community, there are still debates addressing the questions of the most appropriate technique (US vs. CT), in men or in women, in children or in adults, with or without intravenous contrast injection, at standard or at low radiationdose.Inaddition,thepossibleimpactofimagingoncost-effectivecare has to be taken into account. Selected on the only basis of their scientific contributions in the field and on the impact of these contributions, recognized internationalexpertshaveacceptedtoaddressalltheseissuesinthishandbook. This book, entirely dedicated to the appendix and acute appendicitis in adults andchildren,setsouttobeaguideforradiologists,emergencyphysicians,and surgeons,beginnersaswellasexperiencedones.Wewanttoexpressoursincere gratitudetoallrenownedradiologists,emergencyphysicians,andsurgeonswho have contributed to this book with great enthusiasm and support. Brussels, Belgium Caroline Keyzer Pierre Alain Gevenois v Contents Part I Introduction Historical Background, Anatomy and Function, Etiology and Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Caroline Keyzer Part II Treatment Approaches and Issues in Patients with Suspected Acute Appendicitis Clinical Presentation of Acute Appendicitis: Clinical Signs—Laboratory Findings—Clinical Scores, Alvarado Score and Derivate Scores. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 David J. Humes and John Simpson Appendicitis Perforation Rates and Time Interval between Symptom Onset and Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Tehillah S. Menes and Nina A. Bickell Negative Appendectomy Rate and Implications of Removing a Normal Appendix. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Wim T. van den Broek Laparoscopy and Laparotomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Ravikrishna Mamidanna and Omar Faiz Treatment of Appendiceal Perforation . . . . . . . . . . . . . . . . . . . . . . . . 57 Alex M. Almoudaris and Omar Faiz Part III Imaging of Acute Appendicitis in Adults Imaging of Acute Appendicitis in Adults: Radiography. . . . . . . . . . . . . 69 Ronald L. Eisenberg Imaging of Acute Appendicitis in Adults: Ultrasonography. . . . . . . . . . 77 R. Brooke Jeffrey vii viii Contents Imaging of Acute Appendicitis in Adults: Computed Tomography . . . . 97 Caroline Keyzer and Pierre Alain Gevenois Ultrasonograpy Versus Computed Tomography: Evidence-Based Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Caroline Keyzer and Pierre Alain Gevenois Imaging of Acute Appendicitis in Adults: MRI. . . . . . . . . . . . . . . . . . . 117 Christine Schmid-Tannwald and Aytekin Oto Imaging of Acute Appendicitis in Adults: Current Practices in Pregnant Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Tracy A. Jaffe Part IV Imaging of Acute Appendicitis in Children Imaging of Acute Appendicitis in Children: Radiography. . . . . . . . . . . 143 Daniel N. Vinocur and Edward Y. Lee Imaging of Acute Appendicitis in Children: Ultrasonography. . . . . . . . 151 Herma C. Holscher Imaging of Acute Appendicitis in Children: Computed Tomography Including Radiation Issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Andrew J. Spencer, Megan R. Saettele, and Lisa H. Lowe US Versus CT: Evidence-Based Medicine and Cost-Effectiveness in Imaging Acute Appendicitis in Children. . . . . . . . . . . . . . . . . . . . . . 177 Shyama Kamat, Barbara M. Garcia Peña, Craig Blackmore, and L. Santiago Medina Imaging of Acute Appendicitis in Children: MRI. . . . . . . . . . . . . . . . . 183 Marcus Hörmann Part V Imaging Findings of Other Appendiceal Diseases, Impact of Imaging on Negative Appendectomy Rate, and Radiation Dose Optimization Spontaneously Resolving and Chronic Appendicitis . . . . . . . . . . . . . . . 191 Lodewijk P. J. Cobben and Julien B. C. M. Puijlaert Imaging of Primary Appendiceal Neoplasms . . . . . . . . . . . . . . . . . . . . 199 Theodora A. Potretzke and Perry J. Pickhardt Impact of Imaging on Negative Appendectomy Rate. . . . . . . . . . . . . . . 221 Courtney A. Coursey and Ricardo D. Moreno Contents ix Radiation Dose from MDCT Examinations for Suspected Acute Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233 Denis Tack and Caroline Keyzer Part VI Concluding Remarks Summary and Perspectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251 Caroline Keyzer and Pierre Alain Gevenois Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253 Part I Introduction Historical Background, Anatomy and Function, Etiology and Epidemiology Caroline Keyzer Contents Abstract This introduction presents the history of the 1 HistoricalBackground............................................ 3 recognition of the appendix as the organ respon- sibleforadiseasewithahighmortalityrateinthe 2 AnatomyandFunction........................................... 4 previous century and called acute appendicitis. 3 EtiologyandEpidemiology..................................... 5 This history reveals examples of resistance to 4 Conclusion................................................................ 8 changing concepts and brilliant early observations References.......................................................................... 8 that were not easily accepted in the medical community. The anatomy of the appendix is nowadays well known but its function remains unclear. Acute appendicitis is the most common causeofacuteabdominalpainthatrequiressurgery but, for a disease that is prevalent and apparently simple, there is currently little that is well estab- lished on its etiology. 1 Historical Background Acuteappendicitisisaverycommonacuteabdominal disease but it took several centuries to understand its pathogenesis. Berengario da Capri first described the vermiform appendix in humans in 1521 but it was illustrated in 1492 by Leonardo da Vinci in his ana- tomicdrawingsthatwerenotpublishedbeforethe18th century (Prystowsky et al. 2005; Williams 1983) (Fig. 1).Despitetheseearlydescriptionanddrawings, theroleoftheappendixinacuteinflammatorydiseases oftherightiliacfossa—thatcouldevenleadtodeath— C.Keyzer(&) wasonlyrecognizedandacceptedbythesurgicallobby DepartmentofRadiology,HôpitalErasme, in the late 19th century. Till then, it was indeed con- UniversitéLibredeBruxelles, sidered that the disease we currently know as acute RoutedeLennik,808, appendicitis was one of the cecum, named typhlitis, 1070Brussels,Belgium e-mail:[email protected] even if mostofthe pathologic descriptionoftyphlitis C.KeyzerandP.A.Gevenois(eds.),ImagingofAcuteAppendicitisinAdultsandChildren, 3 MedicalRadiology.DiagnosticImaging,DOI:10.1007/174_2011_210,(cid:2)Springer-VerlagBerlinHeidelberg2011
The list of books you might like
