Value of Contrast Enhanced MDCT in Distinguishing Complicated from Non-Complicated Acute Appendicitis

Objectives: To estimate the value of Contrast enhanced MDCT in preoperative distinguishing complicated from non-complicated acute appendicities.Patients and Methods: All surgical reports of appendec-tomies done from January 2015 to January 2016 were retrospectively checked. Cases were included only if abdominopelvic CE-MDCT scans were done prior to surgery and who underwent appendectomy within the subsequent 24 hours after MDCT imaging and pathology reports confirmed the diagnosis of appendicitis. One hundred and two cases (Males/Females = 87/15) with their age ranged from 14-33 years ±5.4 were included in this study.Results: One hundred and two patients (Males/Females = 87/15) age range (14-33) years ±5.4 complied with the selection criteria. According to radiological, surgical and pathological findings; 76 cases were diagnosed as acute non complicated appendicitis while 26 cases were complicated appendicitis. Complications were as follow: 18 cases perforated acute appendicitis, 2 cases complicated with appendicular mass due to phlegmon and 6 cases were complicated with abscess. The scans also could detect the presence of intraluminal appendicoliths in 48 cases, combined intraluminal + extra luminal appendicoliths in 4 cases, presence of extra luminal air in 14 cases, caecal wall thickening in 59 cases and small bowel reactive dilatation in 6 cases.Conclusion: MDCT using the axial and coronal reformatted images improves the self-confidence in the preoperative diagnosis of acute appendicitis and its complications with high benefits on both the clinical outcome and cost-effectiveness for the patients presented to the hospitals with suspected appendicities.