Authors N. DE VOS (1), F. VANHOENACKER (2) / [1] Ghent University, Ghent, Belgium, Department of Radiology and nuclear medicine, [2] AZ Sint-Maarten, Mechelen, Belgium, Department of Radiology
Introduction Appendicitis is the most common abdominal condition requiring emergency surgery. The exact role of imaging in the work-up of patients presenting at the emergency department with right lower abdominal pain remains unsettled.
Aim
To determine which factors influence the use of abdominal ultrasound (US) and computed tomography (CT) in the work-up of these patients
Methods Data from patients, presenting at the emergency department with right lower abdominal pain between July 2015 and July 2016, were retrospectively reviewed. For each patient, presentation during the night shift, Alvarado score, use of US, use of CT, and final diagnosis were determined. Pearson Chi-Square test was used to determine whether patient age under 18, presentation during night shift or Alvarado score influenced the use of medical imaging.
Results 76 patients were selected (43 females, 33 males). Mean age was 36.7 years (range 5-88). 14 patients were minor (under 18 years old). Imaging (US and/or CT) was performed in 82.9% of patients. Imaging was less frequently performed if the Alvarado score was lower than 5 (p < 0.05). Ultrasound was more frequently performed in minor patients (p < 0.05) and CT was more frequently performed in patients over 18 years old (p < 0.05). Although imaging was more frequently performed during the night shift, this difference was not statistically significant (p = 0.083).
Conclusions Alvarado score and patient age have a statistically significant influence on the use of medical imaging in the work-up of patients presenting at the emergency department with right lower abdominal pain. Presentation during night shift also influences the use of medical imaging, although not statistically significant.
