Abstract
BACKGROUND/OBJECTIVES: In emergency departments (EDs), choosing imaging modalities for adolescents with abdominal pain requires balancing diagnostic accuracy and minimizing radiation exposure. This retrospective study compared imaging modalities in adolescents (16-18 years) presenting with non-traumatic acute abdominal pain between the pediatric ED (PED) and adult ED (AED) in the same institution. METHODS: We conducted a retrospective study in patients aged 16-18 years who presented to AED or PED in the same tertiary university-affiliated hospital due to non-traumatic acute abdominal pain between January 2019 and July 2023 (study period = 55 months). The patient freely decided on the emergency department (ED) to be admitted. RESULTS: This study analyzed 950 patients (683 in AED and 267 in PED). Actionable and surgical emergencies were comparable between both EDs (p = 0.617 and 0.245, respectively). PED physicians used fewer CT scans (28.5% vs. 37.9%, p = 0.006) and fewer CT phases (mean, 0.49 vs. 0.76, p < 0.001). Despite more patients undergoing X-rays in PED (77.9% vs. 61.6%, p < 0.001), the number of X-ray images was lower than in AED (mean, 0.9 vs. 1.1, p < 0.001). PED performed more point-of-care US (POCUS) than AED (28.0% vs. 0.1%, p < 0.001). Both EDs had comparable safety outcomes (revisits and missed surgical emergencies). CONCLUSIONS: PED physicians utilize POCUS more frequently and employ fewer CT scans, X-ray images, and CT phases than AED physicians in adolescents presenting with non-traumatic acute abdominal pain. Despite lower radiation exposure, the PED achieved safety outcomes comparable to the AED's, indicating that a PED-style imaging strategy may be safely applied to adolescent abdominal pain evaluation.