Clinical policy: Critical issues in the evaluation and management of emergency department patients with suspected appendicitis

Ann Emerg Med. 2010 Jan;55(1):71-116. doi: 10.1016/j.annemergmed.2009.10.004.


This clinical policy from the American College of Emergency Physicians is an update of a 2000 clinical policy on the evaluation and management of patients presenting with nontraumatic acute abdominal pain.1 A writing subcommittee reviewed the literature to derive evidence-based recommendations to help clinicians answer the following critical questions: (1)Can clinical findings be used to guide decision making in the risk stratification of patients with possible appendicitis? (2) In adult patients with suspected acute appendicitis who are undergoing a computed tomography scan, what is the role of contrast? (3) In children with suspected acute appendicitis who undergo diagnostic imaging, what are the roles of computed tomography and ultrasound in diagnosing acute appendicitis?Evidence was graded and recommendations were given based on the strength of the available data in the medical literature.

Publication types

  • Practice Guideline

MeSH terms

  • Abdominal Pain / diagnosis*
  • Abdominal Pain / diagnostic imaging
  • Abdominal Pain / etiology
  • Adolescent
  • Adult
  • Appendicitis / complications
  • Appendicitis / diagnosis*
  • Appendicitis / diagnostic imaging
  • Child
  • Contrast Media
  • Emergencies
  • Evidence-Based Medicine
  • Humans
  • Practice Guidelines as Topic
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed
  • Ultrasonography


  • Contrast Media