Monday, October 8, 2012

Imaging for Acute Abdominal Pain in the Emergency Department: Increases Might Signal a CAT-astrophe!

We, along with other journals, have published articles on the need to reduce pediatric exposure to computed tomography (CT) due to the radiation risks. Yet, has that message gotten through emergency departments where many children with acute abdominal pain are evaluated? Fahimi et al. (doi: 10.1542/peds.2012-0739) share the results of a very interesting study using a secondary analysis of a national ambulatory data set looking at patients less than 19 years old evaluated for possible appendicitis. The overall  percentage of children receiving CT scans increased, although there were subsets of children that did not. Just who is more likely to get scanned, and whether that scan is really in the best interest of these young patients form the key-take homes from this study. Take a cut at the data and learn more so your patients might get radiated less in the emergency setting. Perhaps the adage that most appendicitis can be diagnosed on the basis of a history, physical, and some baseline lab data should be reemphasized after reading this particular study.