Positive CT scan: Appendectomy indicated

SAN FRANCISCO, May 28 (UPI) -- U.S. researchers say surgery may be indicated for those with chronic or recurring appendicitis.

Researchers at the University of California, San Francisco, say this type of appendicitis -- much less common than acute appendicitis -- may be diagnosed when patients had normal white blood cell counts and mild pain but positive computed tomography scans.

"The decision to forgo surgery in these patients often results in missed appendicitis, with a possible increased risk of perforation," study co-author Dr. Emily Webb says in a statement. "When the appendix is not completely obstructed, it can result in a milder form of appendicitis that is chronic or recurring, but the three forms of appendicitis, acute, chronic and recurrent, are indistinguishable on CT scans."

Webb and colleagues reviewed CT reports and medical records for 2,283 patients with suspected appendicitis from 2002 to 2007. Of these, 23 percent had CT findings indicating probable or definite appendicitis and of these patients more than 80 percent had the appendix quickly removed.

The study, scheduled to be published in the July issue of Radiology, reported of those with positive CT scans, 10 percent had non-surgical treatments such as antibiotics or drainage. Four patients were lost to follow up and the remaining 3 percent were diagnosed with chronic and recurrent appendicitis and five of these later had the appendix removed -- an average of four months later -- with appendicitis confirmed in all cases.