CT scans change treatment plans in ER patients with suspected appendicitis

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CT scans change the initial treatment plans of emergency physicians in more than one-quarter of patients with suspected appendicitis, according to a study published in the October issue of the American Journal of Roentgenology.

During the study, performed at the University of Washington Harborview Medical Center in Seattle, the authors evaluated 100 adult patients admitted to the ER for symptoms of appendicitis. They assessed and compared the treatment plans of  patients before and after CT.

Results showed that "treatment plans changed in 29 percent 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, MD, 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 Nathan. "Patients can be assured that CT scanning of the appendix adds value to therapeutic decision making, thereby improving their care.