Is the Scout Out? The Utility of Scout Radiographs in the Pediatric Upper Gastrointestinal Exam

Objective: To demonstrate the scout radiograph does not change patient management, alter planning, or contribute to interpretation of the outpatient pediatric upper gastrointestinal fluoroscopic examination (UGI). Materials and Methods: We retrospectively reviewed 197 outpatient pediatric UGIs performed over a two year period. We performed a chart review on all patients to evaluate for potentially clinically significant findings on the scout radiograph. Scout findings were categorized into 4 groups: no new clinically significant findings (group 1), potentially clinically significant findings that were not directly addressed in the electronic medical record (group 2), incidental non-GI findings that necessitated further workup; however were later deemed insignificant (group 3), and clinically significant findings that changed patient GI management, altered the planning of the procedure, or contributed to the interpretation of the fluoroscopic study (group 4). Results: 197 UGIs were analyzed. A significant majority of cases (97.0%) were classified into group 1. Three cases (1.5%) were classified into group 2 with findings not addressed in the medical record. Two cases (1.0%) were classified into group 3, which, after further work-up, were deemed not clinically significant. One case (0.5%) was classified into group 4 which resulted in a change in patient GI management. Conclusion: In our review, there was only 1 case in which the scout radiograph changed patient GI management, with moderate stool burden leading to a miralax cleanout, although there were no cases which altered the planning of the procedure or contributed to the interpretation of the study. The scout radiograph can be omitted and/or substituted with the last image hold function in order to decrease radiation exposure. Address correspondence and reprint requests to Selwan Abdullah, University of Maryland Medical Center, 22 S. Greene Street Department of Diagnostic Radiology & Nuclear Medicine Baltimore, MD 21201 (e-mail: salbabdullah@gmail.com). Received 13 September, 2017 Accepted 13 July, 2018 Conflicts of interest: None Funding Sources: None Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.jpgn.org). © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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