Siewert et al graded the severity of inflammation in acute appendicitis based on the changes on a CT scan. The authors are from Beth Israel Deaconess Medical Center and Harvard Medical School in Boston.
Parameters:
(1) external diameter of the appendix in mm
(2) wall enhancement
(3) adjacent findings
Diameter
Wall Enhancement
Adjacent Findings
Grade
<= 5 mm
none
none
0
6 mm
none
none
1
>= 6 mm
present
none
2
>= 6 mm
present
fat stranding without fluid
3
>= 6 mm
present
fat stranding with fluid
4
NA
NA
inflammatory mass or abscess
5
The presence of Grade 4 or 5 inflammation is associated with a higher rate of open appendectomy.
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