Systematic Review: The Role of Intravenous and Oral Contrast in the Computed Tomography Evaluation of Acute Appendicitis
Title
Systematic Review: The Role of Intravenous and Oral Contrast in the Computed Tomography Evaluation of Acute Appendicitis
Creator
Soucy Zachary; Cheng David; Vilke Gary M; Childers Richard
Publisher
The Journal of Emergency Medicine
Date
2019
2019-12-13
Description
BACKGROUND: This systematic review provides practicing emergency physicians updated information regarding the role of oral and intravenous contrast in the computed tomography (CT) evaluation of acute appendicitis. METHODS: A PubMed literature search was conducted from January 1, 1996 to December 31, 2018 and limited to human clinical trials written in English with relevant keywords. High-quality studies were identified and then underwent a structured review. Recommendations are made based on the literature review. RESULTS: Fifty-seven articles met criteria for rigorous review, of which 14 were appropriate for citation in this review. Excellent evidence shows that oral contrast does not improve the test characteristics of CT with intravenous contrast (IVCT) in the evaluation of adults suspected of having acute appendicitis. Good evidence shows that noncontrast abdominal CTs have excellent test characteristics for this same group of patients. CONCLUSIONS: Considering its downsides and lack of utility, the medical literature does not support using oral contrast in the evaluation of acute appendicitis. There is no direct evidence showing that IVCT is better than a noncontrast CT in the evaluation of acute appendicitis; however, the available literature is consistent with slightly better test characteristics for IVCTs. Still, if IVCT cannot be obtained in a timely manner, noncontrast CTs are extremely accurate in detecting this disease.
Subject
acute appendicitis; contrast; CT
Format
Journal Article
URL Address
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Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
ISSN
0736-4679
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
Update Year & Number
January 2020 Update
Affiliated Hospital
Cleveland Clinic Akron General Hospital
Citation
Soucy Zachary; Cheng David; Vilke Gary M; Childers Richard, “Systematic Review: The Role of Intravenous and Oral Contrast in the Computed Tomography Evaluation of Acute Appendicitis,” NEOMED Bibliography Database, accessed May 8, 2024, https://neomed.omeka.net/items/show/10945.