Pediatric Appendicitis: CT Scans are More Frequent but Less Accurate in Community than in Children's Hospitals

In cases of suspected appendicitis, CT scans were ordered more often than ultrasounds in community hospitals than in children's hospitals, with lower accuracy for both procedures in community hospitals.

In a retrospective cohort study of 423 children (mean age, 11 years) who underwent surgery for suspected appendicitis at a tertiary-care children's hospital, investigators evaluated the imaging frequency and diagnostic accuracy of ultrasound and computed tomography (CT) studies performed at referring community hospitals versus those done at the children's hospital.

During the 2-year study, 395 children (93%) had preoperative imaging (ultrasound in 113, CT in 218, and both in 64). Only 31 (7%) had a normal appendix, and 100 (24%) had perforated appendix. Compared to the children initially evaluated at the children's hospital, the 218 evaluated at community hospitals had 4.4 higher odds of having CT.

CT had an overall sensitivity of 95% for app…

Reviewing Author

Katherine Bakes, MD

Disclosures

RoyaltiesEmergency Medicine Secrets (Elsevier)

Grant/Research SupportDepartment of Justice

Editorial BoardsEmergency Medicine Secrets (Elsevier); Rosen’s Emergency Medicine (Elsevier)

Katherine Bakes, MD

Disclosures

RoyaltiesEmergency Medicine Secrets (Elsevier)

Grant/Research SupportDepartment of Justice

Editorial BoardsEmergency Medicine Secrets (Elsevier); Rosen’s Emergency Medicine (Elsevier)

Pediatric Appendicitis: CT Scans are More Frequent but Less Accurate in Community than in Children's Hospitals

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Reviewing Author