Low-Dose CT Doesn't Impair Clinical Outcomes in Younger Patients with Suspected Appendicitis — Physician’s First Watch

Medical News |
September 13, 2017

Low-Dose CT Doesn't Impair Clinical Outcomes in Younger Patients with Suspected Appendicitis

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Using low-dose — instead of standard-dose — computed tomography doesn't lead to unnecessary appendectomies in young adults with suspected appendicitis, according to a study in the Lancet Gastroenterology and Hepatology.

In South Korea, roughly 3000 patients aged 15–44 with suspected appendicitis who were referred for imaging were randomized to receive either low-dose CT (2 mSv) or standard-dose CT (3–8 mSv) at sites with limited experience with low-dose CT.

Appendectomy was performed in 36% of the low-dose group and 39% of the standard-dose group. The rate of negative appendectomy — an indicator of false-positives — did not differ statistically between the groups (4% and 3%, respectively).

A commentator notes that the results may not translate well to countries with higher obesity rates. Nevertheless, she writes, "the implementation of low-dose appendiceal CT should be a priority, since suspected appendicitis is encountered in nearly every hospital, with the highest incidence in young patients."

Reader Comments (1)

William Babson Jr. MD Surgery, General, United States

Before CT and ultrasound, about 90 % of those whom we thought had appendicitis actually had appendicitis. Now, according to this study it is 95 to 96%. However everyone with abdominal pain gets these tests, which can produce a bill of 1 to 2 thousand dollars. History and physical examination are not taught like they used to.

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