The Role of CT in the Management of Children with Suspected Appendicitis
1Institute of Diagnostic Radiology, Ziv medical Center, Israel
2Department of Pediatric Surgery, Ziv medical Center, Israel
PURPOSE: Acute appendicitis is the most common surgical diagnosis in children presenting with abdominal pain to the emergency department. As of today, there is no agreement about the best diagnostic approach for children having suspected appendicitis, and children with intermediate clinical suspicion comprise the most difficult group. The current recommendation is to perform an ultrasound (US) as a first line modality for the diagnosis of appendicitis, which is consistent with the ALARA (As Low As Reasonably Achievable) concept, striving to keep radiation doses to the minimum. A problem remains in patients whose initial US results are inconclusive. There are two acceptable options how to further treat these patients: Watchful waiting with re-evaluation, or to perform computed tomography (CT) to rule in or rule out acute appendicitis. Our study objective was to characterize those patients having moderate clinical suspicion and non-visualized appendix at US, who could benefit from watchful waiting approach, thus withholding them from CT scans and radiation exposure.