How effective is a screening algorithm for pediatric patients with suspected appendicitis?

Updated: Jul 23, 2018
  • Author: Sandy Craig, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

An algorithm for screening pediatric patients (≤18 y) with suspected appendicitis appears to reduce the use of CT scanning without affecting diagnostic accuracy. [44, 45]  This tool also has implications for reducing the levels of radiation exposure and the cost of using this imaging modality. The algorithm includes pediatric surgery consultation without imaging studies in patients with an unequivocal history; for those with an equivocal history, physical examination, and ultrasonographic findings, the algorithm includes consultation and physical examination before obtaining CT studies. [45]

Investigators analyzed data from 331 pediatric patients with suspected appendicitis 2 years before (41%; n = 136) and 3 years after (59%; n = 195) implementation of the new algorithm and found a significant decrease in the use of CT scanning from 39% to 18%, respectively. [44, 45]  Moreover, although the negative appendectomy rate rose from 9% pre-implementation of the algorithm to 11% post-implementation, this increase was not significant and there was no association between negative appendectomy and CT scan utilization. [44, 45]

Go to Imaging of Appendicitis for more information on this topic.


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