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First published online December 19, 2008
British Journal of Radiology (2009) 82, 482-485
© 2009 British Institute of Radiology
doi: 10.1259/bjr/31522537
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British Journal of Radiology 82 (2009),482-485 ©2009 The British Institute of Radiology

Imaging of patients with clinically suspected appendicitis in the Netherlands: conclusions of a survey

L P COBBEN, MD 1 O J BAKKER, MD 2 J B PUYLAERT, MD, PhD 1 L M KINGMA, MD, PhD 1 and J G BLICKMAN, MD, PhD 3

1 Department of Radiology, Medisch Centrum Haaglanden, Lijnbaan 32, 2501 CK Den Haag, The Netherlands, 2 Department of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands, and 3 Department of Radiology, Universitair Medisch Centrum St Radboud, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands

Correspondence: Lodewijk P Cobben, Department of Radiology, Medisch Centrum Haaglanden, Lijnbaan 32, 2501 CK Den Haag, The Netherlands. E-mail: coblod{at}tiscali.nl

The aim of this study was to summarize the extent of variation in imaging strategies in patients clinically suspected of having appendicitis. By means of a written survey, the policies for the imaging management of patients clinically suspected of having appendicitis in the Netherlands were inventoried. A questionnaire was sent to the departments of surgery and radiology of all 105 Dutch hospitals, including the 8 academic medical centres, in March 2006. Questionnaires were returned from 98 hospitals. It was found that, in the work-up of patients suspected of having appendicitis, ultrasound or CT was performed in a minority of hospitals for 50% or more of these patients. In the majority of hospitals, it was carried out for less than 50% of these patients. There is a widespread variability in pre-operative imaging regardless of hospital type. This survey shows that, despite the ubiquitous presence of ultrasound and CT in Dutch hospitals, the pre-operative imaging work-up in patients clinically suspected of having acute appendicitis does not reflect this, being performed in only a minority of patients suspected of having acute appendicitis. Radiologists and surgeons alike should be aware of the positive impact of adjunctive imaging in this group of patients — most importantly lowering the negative appendicectomy rate and also lowering total hospital costs.






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