At our institution the surgeons decide on the need for imaging in patients
suspected of having an acute abdomen. Rarely would they order a CT. I
usually see them order an ultrasound if any imaging is done.
Most apendectomies are performed during the usaul OR hours and I have not
seen an acute surgery performed after 10PM in the past 6 years. SO my
question would be, " what is the rush?" Why not admit, hydrate and repeat
the examination over the next 12 hours?
This would obviate the issue regarding the T , contrast and anesthesia. The
patient would be well served and the cost for a 23 hour observation is
certainly justifiable when put against the cost of missing an appendicitis.
Martin Herman, M.D.
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