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Some experts recommend liberal use of appendiceal computed tomography (CT) in patients with suspected appendicitis to decrease rates of negative appendectomy. In this study, researchers compared negative appendectomy rates at one hospital before and after implementation of a diagnostic pathway for use of appendiceal CT.
The pathway applied to nonpregnant patients older than 14 years; it dictated that all patients be evaluated by a surgeon before CT. Patients found by the surgeon to have diffuse peritonitis or systemic toxicity were sent directly to the operating room. Among the other patients, males with pain that lasted longer than 48 hours or with low suspicion for appendicitis and all females underwent CT. Patients with negative CT scans …