CT Scans Change Treatment Plans in More Than a Quarter of ER Patients with Suspected Appendicitis

Computed tomography (CT) imaging scans alter the initial treatment plans of emergency physicians in over a quarter of patients with suspected appendicitis, according to new data.

During the study, 100 adult patients admitted to the emergency room (ER) for symptoms of appendicitis were evaluated. The treatment plans of these patients were assessed before and after CT scanning and compared. Results showed that "treatment plans changed in 29% of patients as a result of CT. In many instances, CT ruled out appendicitis when the treatment plan prior to the scan was surgical consultation, eliminating the potential for unnecessary surgery on patients with a normal appendix,” according to Robert O. Nathan, M.D., from the University of Washington Harborview Medical Center (Seattle, WA, USA), and lead author of the study.

"The data suggest that CT can be withheld in patients in whom emergency clinicians rate the likelihood of appendicitis as unlikely but that CT findings are often of benefit when appendicitis is judged to be very likely,” said Dr. Nathan. "Patients can be assured that CT scanning of the appendix adds value to therapeutic decision-making, thereby improving their care.”

The study was published in the October 2008 issue of the American Journal of Roentgenology (AJR).

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University of Washington Harborview Medical Center