Saadat Lily, Helenowski Irene, Mahvi David, Boller Anne-Marie
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Gastrointest Surg. 2016 Jun;20(6):1150-3. doi: 10.1007/s11605-016-3110-6. Epub 2016 Feb 29.
Acute appendicitis is one of the most common surgical emergencies. Our study evaluated patients given the diagnosis of appendicitis and reviewed their workup and clinical outcomes. We specifically focused on the use of oral contrast followed by appendectomy.
We retrospectively reviewed all adult patients given an ICD-9 code for appendicitis at Northwestern Memorial Hospital between January 2000 and September 2010. Complication rates, time to the operating room, and length of hospital stay were compared between patients who received a CT scan and those who did not during the hospitalization for appendicitis.
Average time from Emergency Department to the operating room was found to be statistically longer for patients who underwent a CT scan (10 h: 3, 1548) versus those who did not (6 h: 2, 262) (p < 0.0001). There were 19 patients who had the complication of pneumonia and 4 patients who were diagnosed with acute respiratory distress syndrome postoperatively. Patients who underwent a CT scan and received oral contrast had a statistically higher number of both complications (p < 0.0001).
The use of oral contrast is not necessary for an accurate diagnosis of appendicitis and may be associated with higher complication rates, longer hospital stays, and poor outcomes.
急性阑尾炎是最常见的外科急症之一。我们的研究评估了被诊断为阑尾炎的患者，并回顾了他们的检查过程和临床结果。我们特别关注口服对比剂后行阑尾切除术的情况。
我们回顾性分析了2000年1月至2010年9月在西北纪念医院被赋予国际疾病分类第九版（ICD-9）阑尾炎编码的所有成年患者。比较了阑尾炎住院期间接受CT扫描的患者和未接受CT扫描的患者的并发症发生率、进入手术室的时间和住院时间。
发现接受CT扫描的患者从急诊科到手术室的平均时间在统计学上比未接受CT扫描的患者更长（10小时：3,1548例）对比（6小时：2,262例）（p<0.0001）。有19例患者发生肺炎并发症，4例患者术后被诊断为急性呼吸窘迫综合征。接受CT扫描并服用口服对比剂（造影剂）的患者这两种并发症的发生率在统计学上更高（p<0.0001）。
口服对比剂对于准确诊断阑尾炎并非必要，且可能与更高的并发症发生率、更长的住院时间和不良预后相关。
