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Ultrasound suggests kidney stone, CT scan suggests appendicitis. Which is more reliable?

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General & Family Physician
Practicing since : 1978
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Hi, My wife had sudden pain on sunday night, then the next day morning and later in the afternoon it was severe. After blood test/ urine routine tests, and ultra sound done at a nearby hospital, it was thought to be Kidney stones in urinary tract. WBCs had risen to 0000 count, there were pus cells in urine too, so she had some prescribed painkiller and antibiotics. And later the next day we took her for a second opinion to a urologist at a reputed hospital. Blood test was also done SERUM CEATININE which turned out to be normal, and after CT scan it was later diagonised to be a case of mild appendicitis and CT scan didn't find any kidney stones nor urinary tract stones. Which is more reliable CT scan or ultra sound? The report of CT scan says this "APPENDIX IS DISTENDED WITH AN APPENDICOLITH WITH MILD PERIAPPENDICEAL FAT STRANDING AND PERIAPPENDICEAL MESENTERIC LYMPHADENOPATHY"
Does this require immediate surgery or can we wait until the next episode whenever it occurs? She is back to normal, she didn't vomit, nor was their any fever during the first episode and after that there has been no pain since.

What is the next course of action recommended, should we wait it out for the next episode or choose to do perform surgery. Is surgery the only option?
Posted Tue, 30 Apr 2013 in Abdominal Pain
Answered by Dr. Pavan Kumar Gupta 4 hours later

Thanks for the query.

CT scan is the most ideal imaging procedure for diagnosing appendicitis and its complications. It is a much better investigation as compared to ultrasound.

It not only enables the examiner to differentiate diffuse periappendiceal inflammation from an abscess but also detects many of the diseases included in the differential diagnosis of acute appendicitis.

Perforation of the appendix may occur if left untreated, and it is life threatening. The bacteria escaping can result in peritonitis which can be fatal unless treated quickly with strong antibiotics.

Since the patient has responded very well with the antibiotics and there are no symptoms anymore,the temptation is to wait out for another attack of pain but the fact is that a prompt diagnosis and APPENDICECTOMY gives the best results with full recovery in next 2 to 4 weeks.

Since there is no abscess formation and appendix is distended,the best would be to go for the surgery right now and why to wait for another episode.

There is no treatment for acute appendicitis except surgical removal.

I hope it helps however you may revert to me for any further query.

Best of luck,
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