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Appendicitis & CT

meredith mcbride trauma-list@trauma.org
Wed, 16 Apr 2003 10:11:31 -0700 (PDT)


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This would constitute inappropriate use of imaging to begin with. If history and exam suggest appendicitis, then no additional form of work up yields higher positive predictive value - interview and examination by an experienced clinician is as good as it gets. Simply go to the OR. It's only in the occasional atypical presentation that the addition of imaging of imaging can positively change outcome - primarily by reducing the rate of negative exploration. Observation and serial exam is a reasonable option in this scenario as well, although not as cost effective and sometimes less preferable to the patient.

tony joseph <tjoseph@ihug.com.au> wrote:At 11:35 AM 14/04/03 -0500, you wrote:
What concerns me as an ED physician is that I occasionally see surgeons use
a negative test,ie appendix not seen on either ultrasound or CT as somehow
reassurance that the patient doesn't need an appendicectomy ( when the
history and exam suggest otherwise


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<DIV>This would constitute inappropriate use of imaging to begin with. If history and exam suggest appendicitis, then no additional form of work up yields higher&nbsp;positive predictive value - interview and examination&nbsp;by an experienced clinician is as good as it gets. Simply go to the OR.</DIV>
<DIV>&nbsp;</DIV>
<DIV>It's only in the occasional&nbsp;atypical presentation that the addition of imaging of imaging can positively change outcome - primarily by reducing the rate of negative exploration. Observation and serial exam is a reasonable option in this scenario as well, although not as&nbsp;cost effective and sometimes less preferable to the patient.<BR><BR><B><I>tony joseph &lt;tjoseph@ihug.com.au&gt;</I></B> wrote:</DIV>
<BLOCKQUOTE style="PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #1010ff 2px solid">At 11:35 AM 14/04/03 -0500, you wrote:<BR>What concerns me as an ED physician is that I occasionally see surgeons use<BR>a negative test,ie appendix not seen on either ultrasound or CT as somehow<BR>reassurance that the patient doesn't need an appendicectomy ( when the<BR>history and exam suggest otherwise</BLOCKQUOTE><p><br><hr size=1>Do you Yahoo!?<br>
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