Using limited computed tomography with rectal contrast (CTRC) to diagnose pediatric appendicitis after a negative or inconclusive ultrasonogram boosts imaging sensitivity from 44% to 94% and specificity from 93% to 94%, reported Dr. Barbara M. Garcia Pena of Children's Hospital, Boston.
Of 139 children who underwent ultrasonography, 104 had negative results; 20% were false negatives. There were equivocal results in 13 cases. The children with negative or equivocal results underwent CTRC, which generated only one false-negative result (JAMA 282:1041-46, 1999).
Although CTRC is used successfully in adults, this is the first study to evaluate CTRC in children, the authors said. CTRC should be reserved for children in whom the diagnosis remains uncertain after full clinical evaluation, they said.