Utilization of emergency department computed tomography and otolaryngology consultation in the diagnosis of pediatric peritonsillar abscess
| Autor: | Antonios N. Varelas, Phillip S. LoSavio, Paul E. Casey, Emily Misch, Jill S. Jeffe |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Tonsillitis Computed tomography Lower risk Trismus 03 medical and health sciences Otolaryngology 0302 clinical medicine 030225 pediatrics otorhinolaryngologic diseases medicine Edema Humans Peritonsillar Abscess 030223 otorhinolaryngology Child Referral and Consultation Retrospective Studies medicine.diagnostic_test business.industry Palate General surgery Incidence General Medicine Emergency department University hospital medicine.disease body regions Otorhinolaryngology Uvula Child Preschool Pediatrics Perinatology and Child Health Female medicine.symptom business Emergency Service Hospital Mouth Diseases Tomography X-Ray Computed |
| Zdroj: | International journal of pediatric otorhinolaryngology. 117 |
| ISSN: | 1872-8464 |
| Popis: | To determine whether obtaining a computed tomography (CT) scan in the emergency department (ED) is predictive of peritonsillar abscess (PTA) in the pediatric population, and to evaluate for clinical characteristics that may suggest whether a CT is beneficial in the diagnosis of pediatric PTA.Single-institution retrospective chart review at Rush University Hospitals. Study included pediatric patients, aged 17 or younger, who presented to the ED with suspected PTA over a 6-year period. Patients received a neck CT and/or an official otolaryngology consultation. Relevant demographic and study parameters were collected and statistically analyzed using SPSS.A total of 36 pediatric patients with suspected PTA. Of these, 47.2% (17/36) received a diagnosis of PTA while 52.8% (19/36) received an alternative diagnosis. Patients with PTA were more likely to have trismus (41.2% vs 5.3%; p .01), uvular deviation (94.1% vs 15.8%; p .01), and palatal edema (52.9% vs 10.5%; p .01), compared to patients without PTA. Fewer CT scans were ordered when comparing PTA positive versus negative cohorts (35% vs 63.2%; p = .10), however this was not statistically significant. An otolaryngology consult prior to imaging did significantly reduce the frequency of ordered CT scans (12.5% vs 63.6%; p .01).This is the first study to investigate the benefit of CT imaging in the diagnosis of pediatric PTA and impact of an otolaryngology consult on the frequency of CT scans. Pediatric patients at high risk for PTA based on clinical findings may not require CT imaging for diagnosis. Patients at lower risk may benefit from imaging based on the availability of an otolaryngology consult or expertise of the examiner. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect