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Appendicitis & CT

Ronald Simon trauma-list@trauma.org
Mon, 14 Apr 2003 11:43:31 -0400

I don't get this. There are clearly some cases where the diagnosis is a 
slam dunk and no further studies necessary. But there are times when it 
is not. This is where 10-20% neg AP rate comes from. If you can do a 
test that will significantly reduce this negative rate why not use it? I 
would personally rather have a CT than a neg exploration as i assume my 
patients feel the same way.

Douglas Geehan wrote:

>>  To say the use of all CTs in acute AP is wrong is an overstatement.
>> Ron Simon
>> Dir of Trauma
>> Jacobi Medical Center
> I would agree with this statement; howver, we have been discussing the 
> use of CT for appendicitis (kind of neat since we're on the trauma-L; 
> I guess that answers the question about segregated trauma/ gen surgery 
> call...) specifically.  My personal view is that you request a CT when 
> you think the patient does not have appendicitis.  As I tell my 
> residents, "If you are confident enough to put appendicitis as the 
> reason for the CT on the requisition form, the patient just needs an 
> operation".
> Doug