Impact of radiologic imaging on the surgical decision-making process in suspected appendicitis in children

Academic Radiology
Sylvie KaiserBjörn Frenckner

Abstract

To evaluate how the surgeons' decision-making process in appendicitis in children is affected by radiologic imaging. Prospective study including 593 children with suspected appendicitis was conducted. The surgeon's initial clinical disposition was recorded, designating the patient for operation, observation, or discharge. Thereafter, the patients were randomized to undergo either ultrasound only or ultrasound and abdominal computed tomography. The studies were evaluated by radiologists, who indicated if appendicitis was present or not. After radiology was completed, the surgeon re-examined the patient and made the final disposition. The change of disposition pathway was recorded. Final diagnoses were established by means of surgical, histopathologic, and/or clinical follow-up findings. Two hundred forty-four patients had appendicitis. The initial clinical disposition called for 88 operations, 338 observations, and 167 discharges. In total, 347 patients had their treatment plan changed from the initial disposition, resulting in 252 operations, 65 observations, and 276 discharges. In 11 patients, an unnecessary operation was possibly avoided. In 28 patients who turned out to have appendicitis, a possible inappropriate discharge w...Continue Reading

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Citations

Feb 8, 2006·Pediatric Radiology·George A TaylorDouglas S Smink
Dec 26, 2012·Pediatrics·Jacqueline M SaitoPhillip I Tarr
Mar 24, 2006·AJR. American Journal of Roentgenology·Diana P RodriguezGeorge A Taylor
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Feb 24, 2015·Pediatric Surgery International·Maria MichailidouFizan Abdullah
Jun 11, 2016·Pediatric Radiology·Morgan E TelesmanichR Paul Guillerman
Sep 3, 2011·Clinical Pediatrics·Chieh Jack Chiu, Ioana Bratu
Nov 26, 2010·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Preeyacha PacharnDiane S Babcock
Apr 18, 2012·Pediatrics·Richard G BachurMichael C Monuteaux

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