Imaging Possible Appendicitis With CT

Not Applicable

Completed

• Conditions: Abdominal Pain
• Interventions: Other: abdominal ultrasound; Other: unenhanced abdomino-pelvic CT scan

• Registration Number: NCT03570398
• Lead Sponsor: South Tees Hospitals NHS Foundation Trust

Brief Summary

Pain in the right lower abdomen is one of the commonest reasons patients present to general surgeons as an emergency. Whether or not such patients have appendicitis is crucial to their assessment. In UK practice, when the diagnosis is unclear, ultrasound scanning (US) is commonly used to investigate the problem. US is very safe but it will only visualise the appendix in the minority of cases. As a result, the sensitivity for diagnosing appendicitis in this setting is probably only 5-30%. Alternatively, computed tomography (CT) is an accurate way of diagnosing appendicitis in over 90% of cases. CT scans are readily available and with modern scanners, high quality images can be achieved with lower radiation doses. Unenhanced scanning avoids the use of contrast media and permits further reductions in ionising radiation exposure.

Detailed Description

Pain in the right lower abdomen is one of the commonest reasons patients present to general surgeons as an emergency. Whether or not such patients have appendicitis is crucial to their assessment. In UK practice, when the diagnosis is unclear, ultrasound scanning (US) is commonly used to investigate the problem. US is very safe but it will only visualise the appendix in the minority of cases. As a result, the sensitivity for diagnosing appendicitis in this setting is probably only 5-30%. Alternatively, computed tomography (CT) is an accurate way of diagnosing appendicitis in over 90% of cases. CT scans are readily available and with modern scanners, high quality images can be achieved with lower radiation doses. Unenhanced scanning avoids the use of contrast media and permits further reductions in ionising radiation exposure.

Study Timeline

• Study Start: 2016-07-15
• Primary Completion: 2018-02-14
• Study Completion: 2018-02-14
• Status Verified: 2018-05
• Study First Submitted: 2018-05-25
• Study First Submitted QC: 2018-06-15
• Last Update Submitted: 2018-06-15
• Study First Posted: 2018-06-27
• Last Update Posted: 2018-06-27

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 66

Inclusion Criteria

• Acute presentation with abdominal pain and/or tenderness which is most marked in the right lower abdomen

Exclusion Criteria

• Age<18
• Age>60
• Pregnancy
• Patients with a firm clinical diagnosis of appendicitis where surgical management is indicated at presentation
• Patients who have undergone CT scanning within the past two months
• Patients with cognitive impairment who would lack capacity to give consent
• Inability to understand written or spoken English
• Patients who have previously undergone appendicectomy

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Abdominal Ultrasound	abdominal ultrasound	-
Abdominal CT	unenhanced abdomino-pelvic CT scan	-

Primary Outcome Measures

Name	Time	Method
Feasibility	2 years	As assessed by the rate of refusal to participate amongst eligible patients

Trial Locations

Locations (1)

South Tees Hospitals NHS Foundation Trust; 🇬🇧 Middlesbrough, United Kingdom