Pediatrics & Therapeutics
Open Access

Abstract

The Role of Imaging in Acute Appendicitis among Children from a Community Hospital

Marsha Medows, Francis Tintani, Juanita Neira and Aimen Ben Ayad

Background: Acute appendicitis is one of the most common surgical emergencies with a lifetime prevalence of approximately 1 in 7. Early diagnosis and prompt surgical intervention is the key for successful management of acute appendicitis and avoidance of complications. With increased availability of advanced imaging, computed tomography (CT) has become the primary modality for evaluating patients with abdominal pain in many institutions across the United States. The incidence of appendicitis and it propensity to occur in younger patients strongly argue for judicious use of CT.
Objective: Our goal is to reduce the use of CT scans and potential radiation risk in the diagnosis of acute appendicitis.
Method: We conducted a retrospective chart review of hospital data of patients who presented to the Emergency Department with abdominal 2006 to 2010. Statistical analysis was done using STATA 11.0 statistical software.
Results: There were 175 patients who met the inclusion criteria for the study. There were no statistically significant differences in baseline characteristics between patients with Alvarado ≥ 7 and those with Alvarado<7. Patients with Alvarado ≥ 7 made up 50.9% of our study population. Abdominal CT scan was ordered in 63.4% of the patients; 44.8% with Alvarado ≥ 7. There was no significant difference in proportion with CT scan order between those who had Alvarado score ≥ 7 and those with Alvarado score<7 (p-value 0.19) after adjusting for age, gender and BMI.
Conclusion: We found no significant difference between CT scan order and Alvarado score. There was no significant difference between Alvarado score and gender, race/ethnicity or BMI. Despite the wealth of information regarding the role of clinical skills in reducing the need for imaging in diagnoses of acute appendicitis, our study showed no difference in CT ordering based on clinical presentation.