%0 Journal Article
%T The Effects of Preoperative Imaging on Surgical Outcome for Pediatric Appendicitis Patients Special Issue: Pediatric Surgery
%A Henry Su
%A Laura Nally
%A Jennifer Maddison
%A Yi-Horng Lee
%J International Journal of Clinical Medicine
%P 28-33
%@ 2158-2882
%D 2013
%I Scientific Research Publishing
%R 10.4236/ijcm.2013.47A2007
%X <span style=\"font-family:Verdana;\">Computed tomography (CT) has been the major imaging modality for the diagnosis of appendicitis because of its ex</span><span style=\"font-family:Verdana;\">cellent</span><span> </span><span style=\"font-family:Verdana;\">imaging resolution and the ease of interpretation, but a concern has been raised regarding radiation exposure. We have shifted</span><span> </span><span style=\"font-family:Verdana;\">from CT to ultrasonography (US)</span><span> </span><span style=\"font-family:Verdana;\">as the primary imaging modality because of this concern. A retrospective review is conducted to determine whether a combined US/CT strategy can reduce radiation exposure while maintaining the same surgical outcome.</span><span> </span><span style=\"font-family:Verdana;\">Five hundred eighty-six patients between 10 and 18 years of age who underwent an appen</span><span style=\"font-family:Verdana;\">dectomy from 2007-2011wereincluded in our study. The patients were classified as Early (prior to 7/1/2009) or Late (after 7/1/2009) with the knowledge that a conscientious institutional effort was made to start utilizing US as the pri</span><span style=\"font-family:Verdana;\">mary imaging modality, limiting CT use to selective cases in 2009. The diagnostic imaging studies performed (CT, US or no imaging)</span><span> </span><span style=\"font-family:Verdana;\">were recorded. Operative findings, pathology reports and clinical course were reviewed. The rates of acute appendicitis (AA), negative appendectomies (NA) and perforated appendicitis (PA) were</span><span> </span><span style=\"font-family:Verdana;\">calculated.</span><span> </span><span style=\"font-family:Verdana;\">During the Early period, 49.3% of patients (n</span><span> </span><span style=\"font-family:Verdana;\">=</span><span> </span><span style=\"font-family:Verdana;\">150) had undergone CT scans prior to their appendectomy whereas only 37.9% (n</span><span> </span><span style=\"font-family:Verdana;\">=</span><span> </span><span style=\"font-family:Verdana;\">107) had CT scans during the Late period. Of the CT scans obtained during the Late period, only 18.4%</span><span> </span><span style=\"font-family:Verdana;\">of patients (n</span><span> </span><span style=\"font-family:Verdana;\">=</span><span> </span><span style=\"font-family:Verdana;\">52) had a CT scan first, and 55 CT scans were done after an initial US. Patient disease patterns were similar between Early and Late years. While no difference in NA rates for boys was found between the Early and Late periods, a
%K Appendicitis
%K Computed Tomography
%K Ultrasonography
%K Radiation Exposure
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=34727