“Although medical treatment has proven to be a successful method of treatment of uncomplicated acute appendicitis, there is still controversy over which treatment to apply. It is intended that the computed tomography (CT) appendicitis score, which carries the information of all CT parameters, gives us an idea about the severity of acute appendicitis, such as the Alvarado score.”

“A retrospective analysis was conducted on 138 patients with acute appendicitis who underwent CT between 2015 and 2019. In this study, medical treatment group (n = 60) versus surgical treatment group (n = 78) and successful antibiotic treatment group (n = 23) versus unsuccessful antibiotic treatment group (n = 14) were compared.”

“Appendiceal diameter (P < .001), adjacent organ findings (P = 0.041), the CT appendicitis score (P < .001), the severity of periappendiceal fat stranding (P = .002), appendicolith (P = .001), and intra-abdominal free fluid (P < .001) showed statistically significant differences between the medical and surgical treatment groups. According to the logistic regression test, if the patients are with appendiceal diameter ≥13 mm (OR = 5.1, 95% CI: 1.58-16.50), appendicolith (OR = 4, 95% CI: 1.17-13.63), and intra-abdominal free fluid (OR = 3.04, 95% CI: 1.28-7.20), surgeons should prefer surgical treatment.”

“CT findings may be helpful in acute appendicitis cases about whose treatment surgeons are indecisive, and surgical treatment may be preferred in patients with appendiceal diameter ≥13 mm, intra-abdominal free fluid, appendicolith, high CT appendicitis score, and severe mural enhancement.”

Kus, Ceyda Civan et al. “The role of CT in decision for acute appendicitis treatment.” Diagnostic and interventional radiology (Ankara, Turkey) vol. 28,6 (2022): 540-546. Free Full Text.