Follow-up Study Following Conservative Therapy for Appendicitis Diagnosed Using CT Examinations and CT Findings Predicting Recurrence of Symptoms

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 38; no. 5; pp. 475 - 481
• Main Authors: Kin, Keiwa, Inoue, Etsuo, Iwase, Kazuhiro, Higaki, Jun, Kim, Tonsok, Mikata, Shoki, Miyazaki, Makoto, Kamiike, Wataru
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 2005
• Subjects: appendicitis; conservative therapy; CT; recurrence
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.38.475

The purpose of the present study was to determine the recurrence rate of symptoms suggesting acute appen-dicitis following conservative therapy and feasible CT findings for prediction of recurrence from follow-up ofconservatively treated cases in which thediagnosis of acute appendicitis was confirmed by CT. Subjects and Methods: Between December 1997 and June 2002, we studied 233 patients diagnosed with acute appendicitisconfirmed by CT. Follow-up of at least 6 months was done in the 62 cases treated conservatively. Results: 1) Recurrent right lower abdominal pain was recognized in 14 (33%) of 43 patients treated conservatively andwhose follow-up was completed; appendectomy was done in 9 (21%) and histological examinations of surgi-cally resected specimens showed acute appendicitis in 8 (19%). 2) No significant difference was seen betweenrecurrent and non recurrent cases in the development of positive fecal stones or elevated CT values aroundthe appendix on CT at initial conservative treatment. Appendix enlargement exceeding 9mm in diameter orascites was recognized in CT at initial conservative therapy more often in recurrent than non recurrent cases. Summary: The recurrence rate of acute appendicitis diagnosed by CT following conservative therapy was19-33%. Caution must therefore be exercised regarding the possible recurrence of acute appendicitis afterconservative therapy in cases with enlarged appendix or ascites on CT at the initiation of conservative ther-apy.