Abdominal computed tomography use in the emergency department among children with abdominal pain: a retrospective analysis.

backgroundAcute abdominal pain is a common cause of visits to the pediatric emergency departments (ED). In recent years, abdominal computed tomography (CT) has emerged as an increasingly used imaging modality due to its diagnostic value in the evaluation of abdominal pain. This study aimed to determine the frequency of CT use among children presenting to the ED with abdominal pain, and to identify the factors associated with CT use.

methodsA single-center, retrospective review of medical records was conducted, including children aged 3 to 15 years who presented to the ED at the American University of Beirut Medical Center (AUBMC) with abdominal pain between January 1st and December 31, 2014. Demographic, clinical and laboratory data were collected and analyzed to assess predictors of CT use.

resultsA total of 451 patients were included in the study, of whom 11.8% underwent abdominal CT. Appendicitis was the most common abnormal finding (26%) seen on the abdominal CT scans followed by mesenteric adenitis (25%), while one-quarter of CT scans yielded normal findings. Older age, right lower quadrant (RLQ) pain, leukocytosis, and evaluation by an emergency medicine physician were significant predictors of CT use.

conclusionThis study sheds the light on the potential overuse of abdominal CT scan in children presenting to ED with abdominal pain, exposing this vulnerable population to unnecessary radiation and adding financial burden. Thus, these findings underscore the importance of implementing institutional guidelines and promoting the use of non-ionizing imaging modalities.