ACR Appropriateness Criteria® Suspected Appendicitis-Child

Publication date: May 2019Source: Journal of the American College of Radiology, Volume 16, Issue 5, SupplementAuthor(s): Expert Panel on Pediatric Imaging:, George C. Koberlein, Andrew T. Trout, Cynthia K. Rigsby, Ramesh S. Iyer, Adina L. Alazraki, Sudha A. Anupindi, Dianna M.E. Bardo, Brandon P. Brown, Sherwin S. Chan, Tushar Chandra, Jonathan R. Dillman, Scott R. Dorfman, Richard A. Falcone, Matthew D. Garber, Madeline M. Joseph, Jie C. Nguyen, Nabile M. Safdar, Boaz KarmazynAbstractAcute appendicitis represents the most common abdominal surgical urgency/emergency in children. Imaging remains a central tool in the diagnosis of acute appendicitis and has been shown to facilitate management and decrease the rate of negative appendectomies. The initial consideration for imaging in a child with suspected acute appendicitis is based on clinical assessment, which can be facilitated with published scoring systems. The level of clinical risk (low, intermediate, high) and the clinical scenario (suspicion for complication) define the need for imaging and the optimal imaging modality. In some situations, no imaging is required, while in others ultrasound, CT, or MRI may be appropriate. This review frames the presentation of suspected acute appendicitis in terms of the clinical risk and also discusses the unique situations of the equivocal or nondiagnostic initial ultrasound examination and suspected appendicitis with suspicion for complication (eg, bowel obstruction).The American Coll...
Source: Journal of the American College of Radiology - Category: Radiology Source Type: research