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Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
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Appendicitis-I: Introduction01:22

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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
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Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
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Introduction: MRI and CT scans are crucial advancements in medical imaging techniques, playing a vital role in diagnosing conditions related to the gastrointestinal (GI) system. Each scan serves distinct purposes, targets specific areas, and requires unique nursing duties.
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
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Imaging Studies III: Computed Tomography01:27

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DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
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Ultrasonography01:17

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Ultrasonography is an imaging technique that uses high-frequency sound waves to visualize the body's internal structures. It is a non-invasive and safe procedure that does not involve the use of ionizing radiation, making it widely used in various medical fields. Ultrasonography is used to study heart function, blood flow in the neck or extremities, certain conditions such as gallbladder disease, and fetal growth and development.
During an ultrasonography procedure, a handheld device called...
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Diagnostic imaging for acute appendicitis: interfacility differences in practice patterns.

Maria Michailidou1, Maria G Sacco Casamassima, Omar Karim

  • 1Division of Pediatric Surgery, Center for Pediatric Surgical Clinical Trials and Outcomes Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

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Summary

Children presenting to referring hospitals are more likely to receive CT scans for appendicitis diagnosis. Developing clinical pathways and promoting ultrasound can reduce radiation exposure.

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Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Radiology

Background:

  • Acute appendicitis is a common surgical emergency in children.
  • Imaging modality selection can significantly impact diagnosis and management.
  • Variations in imaging practices exist between healthcare facilities.

Purpose of the Study:

  • To analyze trends and factors influencing imaging modality choices for pediatric acute appendicitis.
  • To investigate interfacility differences in imaging for suspected appendicitis in children.
  • To identify predictors of imaging selection in pediatric appendicitis.

Main Methods:

  • Retrospective review of 232 pediatric appendectomies (2008-2013).
  • Comparison of imaging selection between a children's hospital and referring institutions.
  • Analysis of factors influencing computed tomography (CT) versus other imaging modalities.

Main Results:

  • CT scans were the primary imaging modality in 50% of cases.
  • Referring institutions utilized CT scans more frequently (78% vs. 46%).
  • Children were 5.5 times more likely to undergo CT at referring facilities, independent of clinical factors.

Conclusions:

  • Initial presentation at a referring hospital is a significant predictor for CT scan use in pediatric appendicitis.
  • Clinical pathways are needed to standardize imaging and minimize radiation exposure.
  • Increased access to pediatric abdominal ultrasound should be prioritized.