CT imaging features and clinical evaluation of acute appendicitis in the elderly

Abstract

Objective \nTo investigate the imaging features and clinical features of abdominal non-enhanced CT scan of acute appendicitis in the elderly. \n \n \nMethods \nA total of 46 cases of acute appendicitis patients over 60 years old who were admitted from September 2016 to December 2018 were selected as the acute appendicitis group, including 27 males and 19 females, aged(68.26±6.89)years old, ranging from 60 to 84 years old.In addition, 79 patients over 60 years old with non-acute appendicitis were selected as the non-appendicitis group, including 41 males and 38 females, aged(73.31±9.85), ranging from 60 to 94 years old.The two groups of patients received CT non-enhanced scan , and compared the difference between the abdominal CT images of the two groups of patients on the appendix(including the tube diameter, tube wall, and the condition of the official cavity)and the changes around the appendix(including the fat around the appendix, peritoneum thickening, intestinal gap effusion, and periappendiceal abscess). \n \n \nResults \nOn the CT images, the diameter of appendix tube[(12.21±3.61)mm] in the acute appendicitis group was larger than that in the non-appendicitis group[(6.23±1.36)mm]. Acute appendicitis group appendix fat around the waste stone, wall thickening, appendix cloudy, periappendicural peritoneal thickening, incidence of intestinal clearance around the effusion periappendicural abscess, appendix[21.7%(10/46), 15.2%(7/46), 76.1%(35/46), 15.2%(7/46), 2.2%(1/46), 2.2%(1/46)] were higher than the appendicitis group[1.3%(1/79), 1.3%(1/79), 1.3%(1/79), 0, 0, 0], and the difference was statistically significant(P<0.05). \n \n \nConclusion \nElderly patients with acute appendicitis clinical manifestations are not typical, need to use imaging examination to improve the diagnostic coincidence rate, there is overlap between the appendix diameter and the normal appendix diameter, if relying solely on the diameter of the appendix to diagnose, its specificity is low, should be combined with other signs comprehensive analysis. \n \n \nKey words: \nAcute appendicitis;\xa0Computed tomography;\xa0Perforation;\xa0Abdominal pain