[Skip to Navigation]
Sign In
Invited Commentary
January 20, 2021

Optimizing the Gold Standard—Low-Dose Computed Tomography Modalities as a Part of Clinical Practice in Acute Appendicitis Imaging

Author Affiliations
  • 1Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland
  • 2Department of Surgery, University of Turku, Turku, Finland
  • 3Department of Surgery, Satasairaala Central Hospital, Pori, Finland
JAMA Surg. 2021;156(4):351-352. doi:10.1001/jamasurg.2020.6358

Suspicion of appendicitis is globally one of the most common reasons for emergency surgical visits, with appendectomy as the standard treatment for all appendicitis cases for more than a century, even though both epidemiological and clinical data have shown uncomplicated and complicated acute appendicitis being distinct entities instead of consecutive events. Antibiotics are shown to be a safe and efficient alternative to appendectomy for patients with imaging-confirmed, uncomplicated appendicitis, both in adults1 and children,2 setting new standards for preinterventional appendicitis diagnostics and shifting the emphasis from solely assessing the presence of appendicitis toward distinguishing between uncomplicated and complicated appendicitis with high accuracy. This requires imaging, with computed tomography (CT) being the gold standard in adults. However, the main disadvantage of CT is exposure to radiation. The high appendicitis incidence in adolescents and young adults more sensitive to the late effects of radiation emphasizes the need to reduce the CT dose.

Add or change institution
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×