Moteki and Horikoshi used the maximum depth of intraluminal fluid on CT scan to identify patients with acute appendicitis. The authors are from Fujioa General Hospital in Japan.


Main CT criteria used to identify a patient for acute appendicitis:

(1) evidence of periappendiceal inflammation

(2) external diameter > 6 mm

(3) wall thickness > 3 mm


However, the first finding may be absent in a patient with acute appendicitis, while the second 2 findngs may be found in patients without appendicitis.


If the maximum intraluminal fluid thickness is > 2.6 mm then there was a high likelihood for acute appendicitis.


The sensitivity was 87% and specificity was 85-94% (lower if there was a normal appendix with adjacent pathology causing the abdominal pain).


The rule was especially useful when there was appendicitis without periappendiceal inflammation.


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