I asked a surgeon friend this exact question, or to be precise, why does it seem that the number if CT’s requested by surgeons to rule out appy has gone up? I was told there has been a recent rash of lawsuits for removing normal appendices, thus a reluctance by surgeons to take a patient to the OR without a CT diagnosis. SOme surgeons won’t even accept a phoned-in CT result. They require a signed official CT Report that they can hold up in court if there’s any problems. So much for an acceptable false positive rate.

The hospital should have a clear policy on who should get a CT and this should be agreed upon by the medical staff and approved by administration or the hospital board in order to take the load off these poor ER docs and also to assure consistent quality care.

I was called to see a 17 y/o female patient with right lower quadrant abdominal pain, leukocytosis, and CT scan findings of “early appendicitis” (I didn’t order the scan). Took her to the OR and found right ovarian cysts and normal appendix (but took it out anyway). Parents wanted to sue me for misdiagnosis. You can’t win whichever method you choose. CYA medicine does increase the cost of health care!
Dr. Dagny T.

“I was told there has been a recent rash of lawsuits for removing normal appendices, thus a reluctance by surgeons to take a patient to the OR without a CT diagnosis”

Got news for ya, a “normal” or “negative” CT does not rule out appendicitis. It makes it less likely but does not rule it out.