A limited number of retrospective studies of pediatric cohorts imaged without IV contrast have shown rates of visualization of the appendix similar to CT performed with IV contrast as well as high sensitivity and specificity for the diagnosis of appendicitis [1,2]. Potential limitations of unenhanced CT include decreased sensitivity and incomplete characterization of complicated appendicitis (eg, perforation and abscess formation) and possibly lower sensitivity for alternative diagnoses [38,39]. There are no data to suggest that CT with and without IV contrast has better diagnostic performance for acute appendicitis or alternative diagnoses than a single phase (CT with or CT without IV contrast) examination. Furthermore, CT with and without IV contrast approximately doubles radiation exposure to the patient. Radiography Abdomen Most studies have shown that in patients stratified as low risk (which varies per study and is based on the system used), imaging for acute appendicitis is not required, and other causes of abdominopelvic pain should be sought [13,16,17,48-50]. Radiographs may identify alternative causes of pain, such as constipation or lower lobe pneumonia [51]. US Abdomen RLQ Most studies have shown that in patients stratified as low risk (which varies per study and is based on the system used), imaging for acute appendicitis is not required, and other causes of abdominopelvic pain should be sought [13,16,17,48-50]. US Abdomen Most studies have shown that in patients stratified as low risk (which varies per study and is based on the system used), imaging for acute appendicitis is not required, and other causes of abdominopelvic pain should be sought [13,16,17,48-50]. US Pelvis Most studies have shown that in patients stratified as low risk (which varies per study and is based on the system used), imaging for acute appendicitis is not required, and other causes of abdominopelvic pain should be sought [13,16,17,48-50].
Suspected Appendicitis Child. A limited number of retrospective studies of pediatric cohorts imaged without IV contrast have shown rates of visualization of the appendix similar to CT performed with IV contrast as well as high sensitivity and specificity for the diagnosis of appendicitis [1,2]. Potential limitations of unenhanced CT include decreased sensitivity and incomplete characterization of complicated appendicitis (eg, perforation and abscess formation) and possibly lower sensitivity for alternative diagnoses [38,39]. There are no data to suggest that CT with and without IV contrast has better diagnostic performance for acute appendicitis or alternative diagnoses than a single phase (CT with or CT without IV contrast) examination. Furthermore, CT with and without IV contrast approximately doubles radiation exposure to the patient. Radiography Abdomen Most studies have shown that in patients stratified as low risk (which varies per study and is based on the system used), imaging for acute appendicitis is not required, and other causes of abdominopelvic pain should be sought [13,16,17,48-50]. Radiographs may identify alternative causes of pain, such as constipation or lower lobe pneumonia [51]. US Abdomen RLQ Most studies have shown that in patients stratified as low risk (which varies per study and is based on the system used), imaging for acute appendicitis is not required, and other causes of abdominopelvic pain should be sought [13,16,17,48-50]. US Abdomen Most studies have shown that in patients stratified as low risk (which varies per study and is based on the system used), imaging for acute appendicitis is not required, and other causes of abdominopelvic pain should be sought [13,16,17,48-50]. US Pelvis Most studies have shown that in patients stratified as low risk (which varies per study and is based on the system used), imaging for acute appendicitis is not required, and other causes of abdominopelvic pain should be sought [13,16,17,48-50].