title: Effect of contrast-enhanced computed tomography on diagnosis and management of acute abdomen in adults.
abstract: OBJECTIVE
  To determine the impact of computed tomography (CT) on the diagnosis and treatment plan in patients with acute abdominal pain.
  
  
  METHODS
  A prospective study was undertaken in 125 adult patients presenting with acute abdominal pain (74 men and 51 women; 40.2 +/- 19.3 years; range, 18-92). Changes in diagnosis, gain in percentage diagnostic certainty and changes of treatment plan of the surgeons in the emergency department before and after CT were evaluated. Pre- and post-CT diagnoses were compared with the final diagnoses.
  
  
  RESULTS
  CT findings changed the initial diagnosis in 40 (32.0%) patients. The diagnostic certainty was 58.3 +/- 22.9% before CT, and its gain after CT was 21.9 +/- 18.5 points (P < 0.0001). Post-CT diagnoses were consistent with the final diagnosis in 116 patients (92.8%), while pre-CT diagnoses were correct in 89 patients (71.2%; P < 0.0001). Initial treatment plans were changed in 31 (24.8%) patients after CT. In 57 (45.6%) patients, CT information changed diagnoses and/or treatment plans. No significant differences were observed in the diagnosis, diagnostic certainty and treatment plan among four surgeons.
  
  
  CONCLUSIONS
  Contrast-enhanced CT frequently changed the clinical diagnoses with increased diagnostic certainty and the initial treatment plans.
authors.affiliation: Department of Radiology, Motojima General Hospital, Gunma, Japan. yoshito@xa2.so-net.ne.jp
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tsushima
authors.forename: Shuji
authors.initials: S
authors.lastname: Yamada
authors.forename: Jun
authors.initials: J
authors.lastname: Aoki
authors.forename: Teiji
authors.initials: T
authors.lastname: Motojima
authors.forename: Keigo
authors.initials: K
authors.lastname: Endo
mesh_terms: D000006:Abdomen, Acute / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000000981:diagnostic imaging; D003287:Contrast Media; D003937:Diagnosis, Differential; D004239:Diverticulitis, Colonic / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media