Radiological-pathological Discordance in a Patient With Appendicitis Findings on Computed Tomography

Year 2014, Volume: 3 Issue: 2, 186 - 187, 01.05.2014

Leman Günbey Karabekmez Gökhan Karaca Selma Çukur Rula Şahin Sıddıka Halıcıoğlu

https://doi.org/10.5505/abantmedj.2014.35229

Abstract

Computed tomography CT is a commonly used imaging modality with a high sensitivity and specificity in the diagnosis of acute appendicitis. Despite inflammatory changes of appendix seconder to bile leakage can cause CT findings of appendicitis, pathologically this condition is not considered as acute appendicitis since the inflammation begins from the serosal surface. In this study a case with right lower quadrant pain and appendicitis findings on CT but which was not considered as appendicitis pathologically is presented and discussed.

Keywords

Periappendicitis, computed tomography, appendicitis

Bilgisayarlı Tomografide Apandisit Bulguları Olan Hastada Radyolojik- Patolojik Uyumsuzluk

Abstract

Bilgisayarlı Tomografi BT akut apandisit tanısında yüksek özgüllük ve duyarlılığa sahip ve yaygın kullanımı olan bir görüntüleme yöntemidir. Safra kaçağına bağlı apendikste inflamatuar değişiklikler BT’de apandisit bulgularına neden olmakla birlikte patolojik olarak bu durum serozal yüzeyden başlayan inflamasyon nedeni ile akut apandisit olarak kabul edilmemektedir. Bu çalışmada sağ alt kadran ağrısı olan ve bilgisayarlı tomografide apandisit bulguları bulunan, ancak histopatolojik incelemesi apandisit ile uyumlu olmayan bir olgu sunularak tartışıldı.

Keywords

Periapandisit, bilgisayarlı tomografi, apandisit

References

• 1) Malone A.J., Wolf C R., MaImed A.S., Melliere B.F.,Diagnosis of Acute Appendicitis:Value of Unenhanced CT, AJR 1993;60:763-766.
• 2) Schaefer-Prokop C, Jörgensen M: Gastrointestinal Tract, In: Prokop M, Galanski M (Eds): Computed Tomography of the Body, Thieme, Ludwigsburg, Germany 2003:573-575.
• 3) Soyer P, Dohan A, Eveno C, Naneix AL, Pocard M, Pautrat K, Hamzi L, Duteil C, Lavergne-Slove A, Boudiaf. Pitfalls and mimickers at 64-section helical CT that cause negative appendectomy: an analysis from 1057 appendectomies, M.Clin Imaging. 2013 Jul 8 doi:pii: S0899-7071(13)00130-7.
• 4) Wijetunga R., Tan BS, Rouse Jc, Bigg-Withe GW, Doust BD. Diagnostic Accuracy of Focused Appendiceal CT in Clinically Equivocal Cases of Acute Appendicitis, Radiology 2001; 221: 747-753.
• 5) Carr NJ. The pathology of acute appendicitis, Ann Diagn Pathol 2000;4(1):46-58.
• 6) Ackerman NB, Sillin LF, Suresh K.Consequences of intraperitoneal bile: Bile ascites versus bile peritonitis. Am J Surg. February 1985;149:244–246