Protocol Based Selective Imaging Versus Routine Computed Tomography or Ultrasound in Suspected Appendicitis

Protocol Based Selective Imaging Versus Routine Computed Tomography or Ultrasound in Suspected Appendicitis (PROSECCO)

The goal of this clinical trial is to compare protocol based selective imaging to routine imaging in adult patients with suspected appendicitis. The main question[s] it aims to answer are:

• Does protocol based selective imaging using clinical scoring affect clinical outcome?
• Does protocol based selective observation combined with score based selective imaging affect clinical outcome?

Participants will be randomized into three groups:

• Selective imaging based on Adult Appendicitis Score
• Selective observation based on Appendicitis Severity Score combined with selective imaging based on Adult Appendicitis Score
• Routine imaging using ultrasound and/or computed tomography

Researchers will compare selective imaging groups separately with routine imaging to see if number of negative appendectomies or number of complicated appendicitis is not significantly increased.

Inclusion Criteria:

- Suspicion of appendicitis

Exclusion Criteria:

• Time from symptom onset over 72 hours
• Age <18 years
• Pregnancy, ruled out by serum or urine HCG measurement in 18- to 49-year-old women
• CT-scan or ultrasound already done within the last 3 days (72 hours)
• Clinical suspicion of other disease or other reason to perform imaging study
• Recruited earlier to the same trial