When many people experience stomach pain, there is a high probability that they will not consider that it is appendicitis. Because when appendicitis attacks, its symptoms are somewhat similar to normal stomach pain in the human body, so most people think that their appendicitis is just an ordinary stomach pain. Appendicitis must be discovered in time, otherwise it will threaten people's lives. So can appendicitis be detected by CT? When examining appendicitis, we usually look at medical history and physical signs. Generally speaking, physical signs may be easier for professionals. Non-professionals can actually do this examination themselves. One is tenderness, which is what we call pressing it. There is also a kind of tenderness called rebound pain. After pressing down, quickly withdrawing your hand, we call it rebound pain. Tenderness, rebound pain and abdominal muscle tension. Our stomach is usually very soft, and it is very soft when we relax. But at this time, especially in the abdomen of young men, you will feel that the stomach is sometimes like a door panel, extremely tense and extremely hard. We call this muscle tension. If these three symptoms appear, tenderness, rebound pain, and abdominal tension, we call it the manifestations of peritonitis. This is the physical examination. There are also some more interesting signs. For example, if we stomp our right foot hard, we will feel pain in the right lower abdomen, which is a typical physical sign. There are also some other tests, such as the colon inflation test. If you press upward along the colon starting from the left descending colon, you will feel pain in the lower right abdomen. This is also relatively strong evidence, and it is mainly a physical sign. The rest is to go to the hospital for some routine tests, such as biochemical tests, routine blood tests. Routine blood tests will show an increase in white blood cell count. We have now developed some other C-reactive proteins, such as CRP, which will increase significantly after the test. These all indicate signs of inflammation, but they are not specific. If you have inflammation in other parts of your body, such as pneumonia, it will also increase, and the white blood cell count will also increase. It also has to be combined with physical signs. In addition, B-ultrasound is a relatively specific examination. Generally speaking, the accuracy of B-ultrasound examination can reach over 85% for those with more experience. Then CT, especially enhanced CT, has a higher accuracy rate. There are two relatively famous studies in the UK, one of which was conducted at the end of the last century. The more representative one was that emergency patients suspected of having acute appendicitis went for CT scans. Both studies involved 100 patients, and 96% and 98% respectively were suitable for surgery. This is in line with our previous typical reports and the misdiagnosis rate of acute appendicitis can be as high as 15% to 20%, which significantly improves the accuracy of preoperative diagnosis. So, in our hospital, for cases with unclear diagnosis, generally speaking, we will resort to enhanced CT diagnosis in the end. If the diagnosis is still unclear in the early stages, the test can be repeated within 24 hours. For some special groups of people, such as pregnant patients, we may sometimes rely mainly on B-ultrasound. If B-ultrasound cannot solve the problem, we also have MRI. Basically, through these examinations, most cases of appendicitis can be diagnosed promptly. |
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