Abdominal Pain
Conditions
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.
Interventions
OTHERunenhanced abdomino-pelvic CT scan
unenhanced abdomino-pelvic CT scan
OTHERabdominal ultrasound
abdominal ultrasound
Sponsors
South Tees Hospitals NHS Foundation Trust
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility | 2 years | As assessed by the rate of refusal to participate amongst eligible patients |
Countries
United Kingdom
Outcome results
None listed