Is appendiceal CT scan overused for evaluating patients with right lower quadrant pain?

The American Journal of Emergency Medicine
D B SafranD Oller

Abstract

Reports citing excellent sensitivity, specificity, and predictive accuracy of focused appendiceal computed tomography (CT) and showing an overall reduction in resource use and nontherapeutic laparotomies have led to increasing use of that imaging modality. Diagnostic algorithms have begun to incorporate appendiceal CT for patients presenting to the emergency department with right lower quadrant pain. We present a series of 4 cases in which use of appendiceal CT ultimately led to increased cost, resource use, and complexity in patient care. The results of these cases support an argument against unbridled use of appendiceal CT scanning and reinforce the need for clinical evaluation by the operating surgeon before routine performance of appendiceal CT scan.

Citations

Jun 5, 2007·The American Journal of Emergency Medicine·Robert McKay, Jessica Shepherd
Dec 29, 2006·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christopher C LeeHoward Levinson
Apr 22, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Toms AugustinBurt Cagir

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