About Appendicitis

Appendicitis is an inflammation of the appendix affecting an estimated 7%– 9% of the total population and is the most frequent reason for abdominal surgery among adults and children presenting to the emergency departments with acute abdominal pain. Acute appendicitis is a serious disease which typically requires surgery and if left untreated an inflamed appendix can perforate or burst, greatly increasing the patient's risk for complications, extended hospital stays and even death.

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  • The signs and symptoms of appendicitis are extremely variable, subtle, and generally evolve over time.
  • Distinguishing appendicitis from other diagnoses involving abdominal pain is often a complex task.
  • In addition to a clinical exam and basic laboratory testing (e.g., total WBC count), the use of computed tomography (CT) scanning to help diagnose or rule out appendicitis has become widespread.
CT scanning often presents excellent anatomical clarity as well as several well-documented downsides, including exposure to ionizing radiation, risks associated with the use of intravenous contrast dye, overall time to schedule and conduct a CT, increased resource use, increased length of stay, and cost (ACEP Clinical Policy). The risks relative to radiation exposure depend on both sex and age at exposure, with children and pregnant or potentially pregnant females at highest risk (Brenner). According to the New England Journal of Medicine, children are at significantly greater risk from CT because they are inherently more radiosensitive and because they have more remaining years of life during which a radiation-induced cancer could develop. Therefore, the ability to identify patients with low probability of appendicitis and potentially reduce CT imaging in that patient population would be of great value to clinicians and patients alike.

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FDA Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging