To the Editor: When abdominal CT is performed in children with acute abdominal pain, findings are sometimes concerning for Crohn’s disease (CD). However, these findings may represent other conditions. We aimed to develop a tool kit to guide the extent of CD workup needed in these patients. We retrospectively gathered data from medical charts and
via telephone follow-up of all pediatric patients admitted to our medical center due to acute abdominal pain and who underwent emergency abdominal CT during 2018–2020. When CT scans suggested CD, scans were revised using EMBARK criteria [
1]. One hundred and eighty-two children were included in the study and tomographic findings were concerning for CD in 33, who were followed-up for 7.5 (10–18) mo. CD was confirmed in five patients. The following were found to be significantly associated with CD when compared to patients without CD: grade 3 EMBARK severity score (100% vs. 3.6%, respectively,
P < 0.001, sensitivity = 100%, specificity = 96%, PPV = 83%, NPV = 100%); grade 2/3 EMBARK length score (80% vs. 7.1%,
P < 0.001, sensitivity = 80%, specificity = 93%, PPV = 67%, NPV = 96%), sonographic concern for CD (100% vs. 17.9%,
P = 0.004, sensitivity = 100%, specificity = 84%, PPV = 50%, NPV = 96%), anemia (100% vs. 14.3%,
P < 0.001, sensitivity = 100%, specificity = 86%, PPV = 55%, NPV = 100%), fecal calprotection > 200 µg/mg (100% vs. 10%,
P = 0.005, sensitivity = 100%, specificity = 90%, PPV = 80%, NPV = 100%), and growth deceleration (60% vs. 10.7%,
P = 0.03, sensitivity = 60%, specificity = 85%, PPV = 43%, NPV = 92%). …
