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Investigators compared utilization of computed tomography (CT) before and after implementation of a new institutional algorithm for evaluating patients aged 18 and younger with suspected acute appendicitis. Only patients who underwent operative intervention were included in the analysis.
The algorithm involved early pediatric surgery consultation (prior to CT) for patients with the following: (1) unequivocal history and physical exam for appendicitis, (2) equivocal history, physical exam, and ultrasound results, or (3) suspected perforated appendicitis. Patients with appendicitis detected by ultrasound received surgical intervention without CT imaging, while patients with equivocal physical exams and negative ultrasound results were consider…