title: Extra-appendiceal findings in pediatric abdominal CT for suspected appendicitis.
abstract: BACKGROUND
  Much has been written regarding the incidence, types, importance and management of abdominal CT incidental findings in adults, but there is a paucity of literature on incidental findings in children.
  
  
  OBJECTIVE
  We sought to determine the prevalence and characteristics of extra-appendiceal and incidental findings in pediatric abdominal CT performed for suspected appendicitis.
  
  
  METHODS
  A retrospective review was performed of abdominal CT for suspected appendicitis in a pediatric emergency department from July 2010 to June 2012. Extra-appendiceal findings were recorded. Any subsequent imaging was noted. Extra-appendiceal findings were divided into incidental findings of doubtful clinical significance, alternative diagnostic findings potentially providing a diagnosis other than appendicitis explaining the symptoms, and incidental findings that were abnormalities requiring clinical correlation and sometimes requiring further evaluation but not likely related to the patient symptoms.
  
  
  RESULTS
  One hundred sixty-five children had abdominal CT for suspected appendicitis. Seventy-seven extra-appendiceal findings were found in 57 (34.5%) patients. Most findings (64 of 77) were discovered in children who did not have appendicitis. Forty-one of these findings (53%) could potentially help explain the patient's symptoms, while 30 of the findings (39%) were abnormalities that were unlikely to be related to the symptoms but required clinical correlation and sometimes further work-up. Six of the findings (8%) had doubtful or no clinical significance.
  
  
  CONCLUSIONS
  Extra-appendiceal findings are common in children who undergo abdominal CT in the setting of suspected appendicitis. A significant percentage of these patients have findings that help explain their symptoms. Knowledge of the types and prevalence of these findings may help radiologists in the planning and interpretation of CT examinations in this patient population.
authors.affiliation: Department of Radiology, The Children's Hospital of Philadelphia, 3W47 Main Building, 324 S. Thirty-fourth St., Philadelphia, PA, 19104, USA, halversonm@email.chop.edu.
authors.forename: Mark
authors.initials: M
authors.lastname: Halverson
authors.forename: Jorge
authors.initials: J
authors.lastname: Delgado
authors.forename: Soroosh
authors.initials: S
authors.lastname: Mahboubi
mesh_terms: D000293:Adolescent; D001064:Appendicitis / Q000175:diagnosis*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging; D003287:Contrast Media; D003937:Diagnosis, Differential; D003974:Diatrizoate Meglumine; D004636:Emergency Service, Hospital; D005260:Female; D052776:Female Urogenital Diseases / Q000000981:diagnostic imaging; D005767:Gastrointestinal Diseases / Q000000981:diagnostic imaging; D006801:Humans; D033162:Incidental Findings; D008171:Lung Diseases / Q000000981:diagnostic imaging; D008297:Male; D052801:Male Urogenital Diseases / Q000000981:diagnostic imaging; D061330:Multidetector Computed Tomography; D011860:Radiography, Abdominal; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D003974:Diatrizoate Meglumine