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