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Pediatric appendicitis: pathophysiology and appropriate use of diagnostic imaging

Published online by Cambridge University Press:  21 May 2015

Gerald D.G. Brennan
Gerald D.G. Brennan*
Affiliation:
Section of Pediatric Emergency Medicine, Department of Pediatrics and Child Health, Children's Hospital of Winnipeg, University of Manitoba, Winnipeg, Man
*
Children’s Hospital Emergency, University of Manitoba, 840 Sherbrook St., Winnipeg MB R3A 1S1

Abstract

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Evaluating children for appendicitis can be extremely difficult, and various strategies have been developed to improve the precision of preoperative diagnosis. Among these, ultrasound and computed tomography (CT) are now widely used but remain controversial. Although CT scanning is superior to ultrasound in terms of diagnostic accuracy for appendicitis, the large dose of ionizing radiation from CT and the risk of subsequent radiation-induced malignancy (RIM) are of particular concern in pediatric patients. This article reviews the literature on the pathophysiology, morbidity and mortality of appendicitis, summarizes the data regarding pediatric imaging in appendicitis, provides a practical approach to imaging for clinicians who evaluate pediatric patients, and makes recommendations for reducing the risk of RIM in pediatric patients.

Keywords

appendicitisinfantchildadolescentultrasonographycomputed tomographyCTradiation-induced malignancy
Type
Education • Éducation
Information
Canadian Journal of Emergency Medicine , Volume 8 , Issue 6 , November 2006 , pp. 425 - 432
Copyright
Copyright © Canadian Association of Emergency Physicians 2006

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