Are negative appendectomies still acceptable?

Background The goal was to ascertain if there was a significant change in the negative appendectomy (NA) rate in our community hospital with the increased use of computed tomography (CT). Methods This was a retrospective chart review of all appendectomies for acute disease performed at our institution from January 2000 to December 2002. There is no established protocol; therefore, CT scans were performed at the discretion of the involved physicians. The results of the physical exams, CT scans and pathology were recorded. Results Three hundred eighty-nine appendectomies were performed for appendicitis. There was a progressive increase in the use of CT: 52% in 2000, 74% in 2001, and 86% in 2002. There was also a decrease in the NA rate over the 3 years: 17% in 2000, 9% in 2001 and 2% in 2002. The perforated appendicitis rate decreased from 25% in 2000 to 9% in 2002. Conclusion The appropriate utilization of CT scan as an aid in the diagnosis of acute appendicitis should decrease the NA rate to 2%.