Logo

Log In Sign Up |  An official publication of: American College of Emergency Physicians
Navigation
  • Home
  • Multimedia
    • Podcasts
    • Videos
  • Clinical
    • Airway Managment
    • Case Reports
    • Critical Care
    • Guidelines
    • Imaging & Ultrasound
    • Pain & Palliative Care
    • Pediatrics
    • Resuscitation
    • Trauma & Injury
  • Resource Centers
    • mTBI Resource Center
  • Career
    • Practice Management
      • Benchmarking
      • Reimbursement & Coding
      • Care Team
      • Legal
      • Operations
      • Quality & Safety
    • Awards
    • Certification
    • Compensation
    • Early Career
    • Education
    • Leadership
    • Profiles
    • Retirement
    • Work-Life Balance
  • Columns
    • ACEP4U
    • Airway
    • Benchmarking
    • Brief19
    • By the Numbers
    • Coding Wizard
    • EM Cases
    • End of the Rainbow
    • Equity Equation
    • FACEPs in the Crowd
    • Forensic Facts
    • From the College
    • Images in EM
    • Kids Korner
    • Medicolegal Mind
    • Opinion
      • Break Room
      • New Spin
      • Pro-Con
    • Pearls From EM Literature
    • Policy Rx
    • Practice Changers
    • Problem Solvers
    • Residency Spotlight
    • Resident Voice
    • Skeptics’ Guide to Emergency Medicine
    • Sound Advice
    • Special OPs
    • Toxicology Q&A
    • WorldTravelERs
  • Resources
    • ACEP.org
    • ACEP Knowledge Quiz
    • Issue Archives
    • CME Now
    • Annual Scientific Assembly
      • ACEP14
      • ACEP15
      • ACEP16
      • ACEP17
      • ACEP18
      • ACEP19
    • Annals of Emergency Medicine
    • JACEP Open
    • Emergency Medicine Foundation
  • About
    • Our Mission
    • Medical Editor in Chief
    • Editorial Advisory Board
    • Awards
    • Authors
    • Article Submission
    • Contact Us
    • Advertise
    • Subscribe
    • Privacy Policy
    • Copyright Information

Too Many CT Scans for Pediatric Nontraumatic Abdominal Pain

By Will Boggs, MD (Reuters Health) | on October 2, 2017 | 1 Comment
Latest News
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version

Emergency department (ED) computed tomography (CT) imaging rates for children with nontraumatic abdominal pain have changed little since 2007, although pediatric EDs are more likely than general EDs to use the recommended ultrasound as a first imaging procedure.

You Might Also Like
  • Too Many CT Scans for Pediatric Nontraumatic Abdominal Pain
  • Appendicitis Calculator Quantifies Risk in Children with Acute Abdominal Pain
  • A Rash Plus Abdominal Pain May Equal Henoch-Schönlein Purpura

“I believe that the dissemination of pediatric radiology protocols used in pediatric EDs to general EDs may help minimize radiation exposure in children,” Dr. Joanna S. Cohen from George Washington University, Washington, DC, told Reuters Health by email. “These protocols generally emphasize a stepwise approach to management, with ultrasound first and CT only if the diagnosis remains unclear after the ultrasound.”

Between 1999 and 2017, the use of CT for children presenting to EDs with nontraumatic abdominal pain increased from 2 percent to 16 percent, even though ultrasound-first paradigms are most cost-effective for imaging pediatric appendicitis.

Dr. Cohen’s team used the ED data set from the National Hospital Ambulatory Medical Care Survey, covering 2007 through 2014, to investigate national trends in CT and ultrasound imaging for the evaluation of nontraumatic abdominal pain among children presenting to general and pediatric EDs.

ED visit rates for these patients did not change significantly during the study period, according to the September 15 Pediatrics online report. Among the 5,036 ED visits included in the study, 14.6 percent prompted only a CT scan, 10.9 percent only an ultrasound, and 1.9 percent both tests, resulting in a final diagnosis of appendicitis in 3.7 percent of the patients. The overall rates of CT and ultrasound use for these patients did not change significantly between 2007 and 2014.

Pediatric EDs were 66 percent less likely than general EDs to use CT and 2.14-fold more likely than general EDs to use ultrasound. Pediatric and general EDs did not differ in their use of both CT and ultrasound or in their use of any imaging to assess pediatric nontraumatic abdominal pain.

“I think it’s most interesting that while we have seen a plateau in CT imaging for children with abdominal pain, it is still more likely that a child with abdominal pain evaluated in a general ED will receive a CT compared to a similar patient seen in a pediatric-specific ED,” Dr. Cohen said. “There is still more work to be done to standardize care of pediatric patients among EDs.”

“The majority of children receive emergency care in general EDs,” she said, “so optimizing radiation exposure in children really depends on collaboration with our general emergency medicine colleagues.”

Pages: 1 2 | Single Page

Topics: AbdominalClinicalCT ScanDiagnosisEmergency DepartmentEmergency MedicineEmergency PhysiciansEvidenceGastrointestinalGuidelinesImaging & UltrasoundPatient CarePediatricsRadiationRecommendationsRisk

Related

  • Case Report: When Syncope Gets Hairy

    June 17, 2025 - 0 Comment
  • Case Report: Rapid Diagnosis of Acute Aortic Dissection with POCUS

    June 11, 2025 - 0 Comment
  • Influenza, Muscle Pain, and an Elevated Serum Creatine Kinase

    May 10, 2025 - 0 Comment

Current Issue

ACEP Now: June 2025 (Digital)

Read More

One Response to “Too Many CT Scans for Pediatric Nontraumatic Abdominal Pain”

  1. January 29, 2018

    Robert A Reply

    How does ultrasound availability (9am-5pm weekdays vs 24/7) differ between sites that only have an adult ED vs adult/peds ED? I suspect that locations that have both (adult and peds ED) may have access to greater resources and more ultrasound availability. While perhaps adult EM providers share part of the blame for treating kids similarly to adults in regards to ordering CTs first, we should also be looking at centers with low rates of CT use in kids to see what they are doing well (greater availability of ultrasound, more experienced radiologists, surgeons who trust ultrasounds, etc).

Leave a Reply Cancel Reply

Your email address will not be published. Required fields are marked *


*
*


Current Issue

ACEP Now: June 2025 (Digital)

Read More

Wiley
  • Home
  • About Us
  • Contact Us
  • Privacy
  • Terms of Use
  • Advertise
  • Cookie Preferences
Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 2333-2603