ירחון החברה הישראלית לפדיאטריה אמבולטורית (חיפ"א) גיליון 2018-2

26 Risks for leukemia were projected between 0.4-1 per 10,000 scans of the abdomen or chest, but 1/5,000 for head CTs in children under 5 (think head injuries). This last statistics may seem un-alarming. But consider that in the United States, where nearly 4 million head, abdominal and chest CT are performed annually with a projected result of nearly 5,000 future cancers. One way to reduce risk in to pediatric patients is by ensuring care by those trained in pediatric care. In a review by Anderson et al, published in Surgery, he demonstrates how children seen in Pediatric centers are more likely to have US, instead of CT to diagnose appendicitis. The opposite occurs in general medical centers. Looking at three years' worth of data for 1,448 pediatric patients in one city, they compared the diagnostic methods in 8 general medical centers compared to those of one children's hospital. The children's hospital used CT less often (23% vs. 70%) and ultrasound, more often (75% vs. 20%). The structure of pediatric care in our country is different than that of the US, as is our use of CT imaging. Data demonstrating use of fewer ionizing radiation studies would be reassuring. Nevertheless, we must always work toward reducing our patient's harm. answers: 1 (b); 2 (c) References: 1. Anderson KT, et al. Imaging Gently? Higher rates if computer tomography imaging for pediatric appendicitis in non-children's hospitals. Presented at the Academic Surgical Congress 2016. Surgery 2017;161(5):1326-1333. 2. Miglioretti DL, et al. The Use of Computed Tomography in Pediatrics and the Associated Radiation Exposure and Estimated Cancer Risk. JAMA Pediatr. 2013;167(8):700-707 3. Coon ER, et al. Update on Pediatric Overuse. Pediatrics 2017;139(2).