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Barium appendicitis: A single institution review in Japan

View Article: PubMed Central - PubMed

ABSTRACT

Aim: To review clinical experience with barium appendicitis at a single institution.

Methods: A retrospective review of patients admitted with a diagnosis of acute appendicitis, from January 1, 2013 to December 31, 2015 was performed. Age, gender, computed tomography (CT) scan findings if available, past history of barium studies, pathology, and the presence of perforation or the development of complications were reviewed. If the CT scan revealed high density material in the appendix, the maximum CT scan radiodensity of the material is measured in Hounsfield units (HU). Barium appendicitis is defined as: (1) patients diagnosed with acute appendicitis; (2) the patient has a history of a prior barium study; and (3) the CT scan shows high density material in the appendix. Patients who meet all three criteria are considered to have barium appendicitis.

Results: In total, 396 patients were admitted with the diagnosis of acute appendicitis in the study period. Of these, 12 patients (3.0%) met the definition of barium appendicitis. Of these 12 patients, the median CT scan radiodensity of material in the appendix was 10000.8 HU, ranging from 3066 to 23423 HU (± 6288.2). In contrast, the median CT scan radiodensity of fecaliths in the appendix, excluding patients with barium appendicitis, was 393.1 HU, ranging from 98 to 2151 HU (± 382.0). The CT scan radiodensity of material in the appendices of patients with barium appendicitis was significantly higher than in patients with nonbarium fecaliths (P < 0.01).

Conclusion: Barium appendicitis is not rare in Japan. Measurement of the CT scan radiodensity of material in the appendix may differentiate barium appendicitis from routine appendicitis.

No MeSH data available.


Related in: MedlinePlus

Abdominal computed tomography scans with axial and coronal views. A and B: High density material is seen inside the swollen appendix (arrows); C and D: High density material is seen inside the swollen appendix and in the peritoneal cavity with a fluid collection (arrow heads). This strongly suggests a perforated appendicitis with residual barium.
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Figure 1: Abdominal computed tomography scans with axial and coronal views. A and B: High density material is seen inside the swollen appendix (arrows); C and D: High density material is seen inside the swollen appendix and in the peritoneal cavity with a fluid collection (arrow heads). This strongly suggests a perforated appendicitis with residual barium.

Mentions: From January 1, 2013 to December 31, 2015, 396 patients were admitted with the diagnosis of acute appendicitis, including 210 males and 186 females. The median age is 37 years, ranging from 5 to 86 years. Of these, 12 patients (3.0%) met the definition of barium appendicitis (Table 1, Figure 1), including ten males and two females, with a median age of 48 years, ranging from 37 to 62 years. Of these 12 patients, the median CT scan radiodensity of material in the appendix was 10000.8 HU, ranging from 3066 to 23423 HU (± 6288.2). According to these data, the CT scan radiodensity of residual barium is generally higher than 3000 HU. If we apply this value as a cutoff, we can identify seven more patients with suspected barium appendicitis based on CT scan radiodensity alone. According to the medical records, these seven patients had no definite history of a preceding barium study, excluding one patient who specifically denied having a barium study. The median CT scan radiodensity of fecaliths in the appendix, excluding patients with barium appendicitis, was 393.1 HU, ranging from 98 to 2151 HU (± 382.0). The CT scan radiodensity of material in patients with barium appendicitis was significantly higher than patients with non-barium fecaliths (P < 0.01).


Barium appendicitis: A single institution review in Japan
Abdominal computed tomography scans with axial and coronal views. A and B: High density material is seen inside the swollen appendix (arrows); C and D: High density material is seen inside the swollen appendix and in the peritoneal cavity with a fluid collection (arrow heads). This strongly suggests a perforated appendicitis with residual barium.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037339&req=5

Figure 1: Abdominal computed tomography scans with axial and coronal views. A and B: High density material is seen inside the swollen appendix (arrows); C and D: High density material is seen inside the swollen appendix and in the peritoneal cavity with a fluid collection (arrow heads). This strongly suggests a perforated appendicitis with residual barium.
Mentions: From January 1, 2013 to December 31, 2015, 396 patients were admitted with the diagnosis of acute appendicitis, including 210 males and 186 females. The median age is 37 years, ranging from 5 to 86 years. Of these, 12 patients (3.0%) met the definition of barium appendicitis (Table 1, Figure 1), including ten males and two females, with a median age of 48 years, ranging from 37 to 62 years. Of these 12 patients, the median CT scan radiodensity of material in the appendix was 10000.8 HU, ranging from 3066 to 23423 HU (± 6288.2). According to these data, the CT scan radiodensity of residual barium is generally higher than 3000 HU. If we apply this value as a cutoff, we can identify seven more patients with suspected barium appendicitis based on CT scan radiodensity alone. According to the medical records, these seven patients had no definite history of a preceding barium study, excluding one patient who specifically denied having a barium study. The median CT scan radiodensity of fecaliths in the appendix, excluding patients with barium appendicitis, was 393.1 HU, ranging from 98 to 2151 HU (± 382.0). The CT scan radiodensity of material in patients with barium appendicitis was significantly higher than patients with non-barium fecaliths (P < 0.01).

View Article: PubMed Central - PubMed

ABSTRACT

Aim: To review clinical experience with barium appendicitis at a single institution.

Methods: A retrospective review of patients admitted with a diagnosis of acute appendicitis, from January 1, 2013 to December 31, 2015 was performed. Age, gender, computed tomography (CT) scan findings if available, past history of barium studies, pathology, and the presence of perforation or the development of complications were reviewed. If the CT scan revealed high density material in the appendix, the maximum CT scan radiodensity of the material is measured in Hounsfield units (HU). Barium appendicitis is defined as: (1) patients diagnosed with acute appendicitis; (2) the patient has a history of a prior barium study; and (3) the CT scan shows high density material in the appendix. Patients who meet all three criteria are considered to have barium appendicitis.

Results: In total, 396 patients were admitted with the diagnosis of acute appendicitis in the study period. Of these, 12 patients (3.0%) met the definition of barium appendicitis. Of these 12 patients, the median CT scan radiodensity of material in the appendix was 10000.8 HU, ranging from 3066 to 23423 HU (&plusmn; 6288.2). In contrast, the median CT scan radiodensity of fecaliths in the appendix, excluding patients with barium appendicitis, was 393.1 HU, ranging from 98 to 2151 HU (&plusmn; 382.0). The CT scan radiodensity of material in the appendices of patients with barium appendicitis was significantly higher than in patients with nonbarium fecaliths (P &lt; 0.01).

Conclusion: Barium appendicitis is not rare in Japan. Measurement of the CT scan radiodensity of material in the appendix may differentiate barium appendicitis from routine appendicitis.

No MeSH data available.


Related in: MedlinePlus