Clinical and CT features of acute perforated appendicitis

Objective: To determine the symptoms, signs and CT features that differentiate perforated from non-perforated appendicitis. Methods: The clinical records including symptoms, signs and laboratory results as well as CT findings of appendicitis in 109 patients were compared between those with and without appendiceal rupture. Results: Duration of symptoms of more than 3 days, right lower abdomen painful mass, CT features of appendiceal wall defect, extraluminal air, extraluminal appendicolith, abscess or phlegmon are features that predict appendiceal rupture with high specificity. Rebound tenderness and guarding, CT findings including appendiceal diameter and bowel wall thickening were more common in perforated appendicitis. Conclusion: CT and clinical bindings can accurately determine appendiceal rupture in acute appendicitis. (authors)