Diagnosing Appendicitis with CT or Ultrasound

When a doctor orders lab tests and diagnostic imaging tests for a patient, the patient may not be clear on the purpose of the test or what the test involves. Most patients trust that the doctor is ordering all the right tests and leaving no stone unturned. However, some doctors still differ in the tests they order even when all the presenting signs and symptoms are the same. 

Testing for Appendicitis

Appendicitis is caused by a blockage inside the appendix. The appendix is a small organ attached to the large intestine, located in the lower right part of the abdomen. Blockage in the appendix can cause pressure, inflammation, and disrupt blood flow. If the blockage is not cleared, it can cause the appendix to burst, spreading infection inside the body called peritonitis. Appendicitis can also cause an abscess to develop in the abdomen, leading to serious infection.

Appendicitis Symptoms 

One of the problems with diagnosing appendicitis is that the signs and symptoms may be different for different people. The most common symptom is pain in the abdomen. However, other symptoms can include:

• Bloating
• Nausea or vomiting
• Low-grade fever
• Loss of appetite 
• Constipation

Some of these symptoms may mirror other conditions, including misdiagnosis in women as pelvic inflammatory disease (PID), urinary tract infection (UTI), or gastroenteritis. A proper diagnosis is important to treat appendicitis and reduce the risk of serious complications, including death. 

Diagnosing Appendicitis

Diagnosing appendicitis generally starts with a physical exam to assess pain and the location of the condition. A blood test may look for white blood cell counts that could indicate an infection. A urine test can rule out other conditions, like a UTI or kidney stones. Imaging tests can give the doctor an inside look at the abdomen to help diagnose problems with the appendix. 

Some of the common imaging tests to evaluate possible appendicitis include X-ray, abdominal ultrasound, computerized tomography scan (CT scan), or magnetic resonance imaging (MRI). In a study in the Journal of the American Medical Association (JAMA), the use of ultrasonography (US) is now preferred by pediatricians over CT, based on concerns over ionizing radiation exposure. 

Appendicitis is one of the most common surgical emergencies for children. Assessment and diagnosis for appendicitis in young children is generally not sufficient without imaging, solely based on history, physical examination, and routine laboratory studies. 

Between 2010 and 2013, US imaging increased 46% and CT scans decreased 48%. However, CT scans have generally better diagnostic use in assessing appendicitis. Despite the inferior reliability of ultrasounds, the frequency of perforated appendix and emergency department revisits remained stable. The proportion of negative appendectomy actually declined over that time. 

Appendicitis Errors and Malpractice

Appendicitis is generally treatable if detected, diagnosed, and managed in a timely manner. Failure to timely diagnose and treat appendicitis may lead to serious consequences, including further injury and death.

At Gilman & Bedigian, we are committed to helping patients and families who have been injured by medical malpractice to obtain compensation. To speak with a member of our personal injury team, fill out an online case evaluation form or call (800) 529-6162 today.