Computerized Axial Tomography

To the Editor.— The patient described in our case report (see p 628 this issue, and pp 530,531) was a young man who had had a severe form of regional enteritis since 1970. Despite his affliction, he was able to work as a ski instructor a year or so before his last hospitalization in 1975. Because of enterocutaneous fistulae, he had recurrent problems that ultimately led to his final hospitalization, which was of eight months' duration. During that time, he had prolonged total parenteral nutrition, an exploratory laparotomy with small bowel resection and drainage of a subphrenic abscess, and multiple abdominal ultrasound studies and various radionuclide scans. Thus, the four computerized axial tomography (CT) scans performed during the final weeks of life constituted only a fraction of his total care and medical expense. However, all of the diagnostic and therapeutic interventions were based on the impression that the patient was