Related Experiment Video

Updated: Aug 6, 2025

Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
05:37

Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion

Published on: August 6, 2019

6.4K

Reduced Computed Tomography for Appendicitis in Children after Implementation of Next-day Surgery Clinic Follow-up

Sydney Ryan1, Nanette C Dudley1, Jeff E Schunk1

  • 1Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah, Salt Lake City, Utah.

Pediatric Quality & Safety
|March 17, 2023
PubMed

Insights

We reduced computed tomography (CT) use for pediatric appendicitis evaluation by implementing a new algorithm. This approach successfully lowered CT scans without increasing hospital resources or adverse outcomes.

Area of Science:

  • Pediatric Emergency Medicine
  • Diagnostic Imaging
  • Surgical Evaluation

Background:

  • Computed tomography (CT) is frequently used for pediatric appendicitis, but concerns exist regarding radiation exposure and resource utilization.
  • Previous strategies to reduce CT use have sometimes led to increased MRI use, longer emergency department (ED) stays, and higher hospitalization rates.
  • There is a need for strategies that decrease CT utilization without negatively impacting patient care or increasing overall hospital resource demands.

Purpose of the Study:

  • To implement and evaluate a diagnostic algorithm aimed at reducing CT utilization in pediatric patients with suspected appendicitis.
  • To assess the algorithm's impact on secondary outcomes, including ultrasound (US) use, hospital admission, ED surgical consultations, return visits, and ED length of stay.
  • To determine if a novel approach incorporating next-day pediatric surgery clinic follow-up could safely reduce CT use.

Main Methods:

  • A retrospective study of 4,577 pediatric patients evaluated for suspected appendicitis between January 2012 and September 2015.
  • Implementation of a new diagnostic algorithm in January 2014, including an option for next-day pediatric surgery clinic follow-up for uncertain cases after initial ultrasound (US).
  • Statistical Process Control was used to compare CT utilization rates before and after algorithm implementation, alongside analysis of secondary outcomes.

Main Results:

  • CT utilization significantly decreased from 13.8% to 6% after algorithm implementation.
  • Forty-eight patients utilized the optional next-day pediatric surgery clinic over a 21-month period.
  • No significant changes were observed in US utilization, hospital admission rates, ED surgical consultations, 7-day ED return visits, or ED length of stay.

Conclusions:

  • The implemented diagnostic algorithm successfully reduced CT utilization for suspected appendicitis in pediatric patients.
  • This strategy achieved reduced CT use without increasing the demand on other hospital-based resources or negatively affecting key secondary outcomes.
  • The inclusion of a next-day pediatric surgery clinic follow-up option appears to be a safe and effective component of this resource-sparing diagnostic approach.

More Related Videos

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction08:26

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction

Published on: March 24, 2023

593
Application of Robot-assisted Pancreaticobiliary Junction Resection in Benign Duodenal Tumors03:37

Application of Robot-assisted Pancreaticobiliary Junction Resection in Benign Duodenal Tumors

Published on: December 20, 2024

587

Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

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...
109
Computed Tomography01:10

Computed Tomography

Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
4.7K
Imaging Studies III: Computed Tomography01:27

Imaging Studies III: Computed Tomography

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...
33
Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

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...
331
Imaging Studies I: CT and MRI01:14

Imaging Studies I: CT and MRI

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...
368
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
142