15 Jun

The role of radiological imaging in the diagnosis of acute appendicitis: SUMMARY Part 2

Unfortunately, studies of radiological techniques in acute appendicitis have been marred by the lack of standardized radiological or even histological criteria for the diagnosis of appendicitis. There are also methodological limitations, including comparison of imaging with initial clinical assessments, lack of blinding, failure to confirm (either by surgery or by thorough and prolonged follow-up) the diagnosis in all patients, lack of acknowledgement of indeterminate test results and failure to measure interobserver variability. Finally, most studies have been conducted by investigators with a high degree of interest and expertise in appendiceal imaging. The applicability of their results to other settings is unclear. You will soon see how easy it is to start the treatment if you have a reliable pharmacy offering Advair Diskus for Asthma for sale or any other medications you may need for the specific medical issue you may have that requires treatment.

Some investigators have reported very high degrees of diagnostic accuracy with advanced radiological techniques, such as graded compression ultrasonography, colour Doppler ultrasonography, and focused helical CT with enteric and/or intravenous contrast. It has even been suggested that all patients with suspected appendicitis should undergo CT scanning. Such a strategy can be effective only if the radiological investigations are undertaken rapidly, are interpreted accurately and definitively, and are used to guide treatment. It seems that such high standards could be achieved only in centres in which emergency medicine, radiology and surgery services are well coordinated, and in which equipment and highly trained personnel are committed to the management of appendicitis. Unfortunately, these conditions are difficult to meet.

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