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AAP Grand Rounds 3:30-31 (2000) CT in Children with Suspected AppendicitisSource: Garcia-Pena BM, Taylor GA, Lund DP, Mandl KD. Effect of computed tomography on patient management and costs in children with suspected appendicitis. Pediatrics. 1999;104(3):440446.
A common diagnostic dilemma in pediatrics is the child with "suspected" appendicitis. Acute appendicitis is the most common cause of emergency surgery in children. Using sensitivity analysis, this study from the Emergency Department [ED] at Childrens Hospital, Boston, examined the cost effectiveness of abdominal computed tomography [CT] scan for the diagnosis of acute appendicitis in children. Three diagnostic strategies were modeled: (1) CT scan on all patients admitted for observation, discharging those with negative scans; (2) CT scan on all patients admitted for observation and admit all with negative CT scans; (3) CT scan on all patients admitted for observation with a WBC >10,000/cc and admit all with negative CT scans. The results of 609 patient charts were reviewed retrospectively. Forty-seven percent (287/609) went directly from the ED to the OR for an appendectomy and an additional 14 with perforation were treated with IV
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