The Role of Abdominal CT in the Management of Acute Abdominal Conditions in Children

Objectives: This study aimed to assess the influence of abdominal computerized tomography (CT) scans on the management of children presenting with acute abdominal conditions, considering concerns regarding radiation exposure. Methods: A retrospective review was conducted of all acute pediatric patients who underwent abdominal CT in a tertiary hospital, during 2018-2019. Results: Over the 2-year period, 976 pediatric patients were admitted due to acute abdominal conditions. Of 197 (20.2%) patients who underwent abdominal CT scans, management plan was modified based on CT results in 67.5%. In non-trauma cases, the impact on the management plan was even more pronounced, affecting 91.2% of patients, and led to invasive procedures (one third), non-invasive actions (one third), or discharge (one third). Multivariate analysis demonstrated a significantly higher odds ratios (OR) for impact on management in non-trauma patients (OR=24) as compared to trauma patients, especially younger (OR=1.58 annually) and male (OR=10.42) patients, and when performed early (OR=2.44, for each day earlier). Trauma patients with a lower body mass index (BMI) (OR=1.02 per percentile decrease) demonstrated a significantly larger impact. Conclusion: These results support a more liberal use of early CT scans in non-traumatic acute pediatric abdominal conditions, especially in younger male patients, with more careful consideration in trauma patients, particularly those with high BMIs.