Children suspected of having appendicitis are more likely to receive CT scans, which involve radiation, if they are evaluated at a general hospital, a new study by Washington University School of Medicine in St. Louis has shown.
Similar patients who went to St. Louis Children's Hospital were more often evaluated with an ultrasound scan, a safer option that uses sound waves instead of radiation to confirm or rule out the need for surgery to remove the appendix.
Use of either scanning technique can potentially reduce the occurrence of unnecessary surgeries and expedite the diagnosis of appendicitis. But recent reports have suggested that the radiation exposures in CT scans can significantly increase children's lifetime cancer risk. As a result, researchers are reassessing the role of CT scans and seeking ways to reduce their use.
The study appears online Dec. 24 in the journal Pediatrics.
"Appendicitis is a very tough diagnosis, because its symptoms overlap with viral infections and other problems," says first author Jacqueline Saito, MD, assistant professor of surgery. "We don't want to operate when the appendix is fine, but if we wait too long, an inflamed appendix can rupture or perforate, making recovery more complicated and much slower."
The appendix is a finger-shaped pouch that extends from the large intestine. Infection or blockage of the appendix causes appendicitis, which can lead to abdominal pain, vomiting and fever.
Saito and her colleagues analyzed case records of 423 children who had appendectomies, or surgery to remove the appendix, at St. Louis Children's Hospital. In 218 patients initially evaluated at Children's Hospital and 205 at general hospitals, researchers reviewed how the patients were evaluated for appendicitis and whether the surgery's results confirmed the diagnosis.