Non Contrast CT in Acute Appendicitis

Acute appendicitis is a prevalent cause of abdominal pain, with an estimated lifetime risk of 7 to 9%.\[1\] Diagnosing appendicitis on CT has a sensitivity and specificity of 87% and 76%, respectively. Classically, diagnosis of acute appendicitis is by identifying an enlarged appendix (greater than 6 mm in diameter) . Some studies suggest using a cut-off value of over 7 mm to improve the prognostic capability of CT. On the other hand, appendicitis is regularly diagnosed using radiology studies. In fact, imaging is often the deciding factor between operative and non-operative management. Though the diagnosis can be clinical following a thorough history and physical, imaging is regularly employed to confirm the diagnosis in question. The most commonly used radiographic study is the CT scan, given its speed, sensitivity, and specificity. US is also relatively useful modality to diagnose acute appendicitis, it has its limitations. Ultrasound is highly operator dependent and tends to work best on individuals with less fat and muscle content in their abdomen (i.e., children). Currently, the negative appendectomy is less than 12% in men but can be up to 33% in women; accurate imaging studies could reduce the number of unnecessary surgeries performed on patients. It is, therefore, essential to know which study will provide the clinician with the most accurate information for their specific clinical scenario.