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Diagnosis impact of CT scans on appendicitis is unclear

A burst appendix can have serious consequences for Oregonians, even though the organ itself doesn't serve a purpose. A failure to diagnose appendicitis can lead to a patient's worsened condition, and can actually be fatal.

A recent study of emergency rooms across the county has shown a large increase in the number of CT scans in children complaining of stomach pain. However, there has been no associated increase in the rate of appendicitis.

A CT scan uses x-rays to give doctors a high-resolution look into the body. But, the growing popularity of CT scans has given rise to concerns over cancer risks later in life. The study shows that between 1998 and 2008, CT scans in children with stomach pain rose from less than one percent to over 15 percent. That amounts to one out of six or seven kids getting a CT scan for these symptoms.

One of the doctors heading the study reportedly said that while CT scans are being used more often, it is not clear whether their use is making a significant impact on treatment being provided. It's estimated that two or three CT scans - also known as CAT scans - can do enough damage to cells to increase a person's risk for cancer. This is especially true in children. While there certainly are benefits to CT scans, it is not known if the benefits track with the associated risks.

The doctor said the scan's popularity may be related to doctors trying to protect themselves against medical malpractice claims for missed appendicitis diagnoses. He said a failure to make a diagnosis is one of the top reasons ER doctors get sued for malpractice. Doctors may also be less likely to do surgery without confirmation of appendicitis.

However, doctors should know how to identify a patient's other signs and symptoms to diagnose appendicitis, even without a CT scan. Moreover, a doctor is always at liberty to go over the possible risks of all options, including a CT scan, with the child's parents. If a doctor fails to do so and therefore fails to diagnose appendicitis, he or she may be liable for any damages the patient might suffer as a result.

Source: NCB News, "Study finds 'dramatic' rise in kids' CT scans," Frederik Joelving, Oct. 8, 2012

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