Evaluation of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause: prospective randomised study.
OBJECTIVE
To evaluate the impact of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause on length of hospital stay and accuracy of diagnosis.


METHODS
Randomised, prospective controlled trial.


METHODS
Teaching hospital in England.


METHODS
120 patients admitted with acute abdominal pain for which no immediate surgical intervention or computed tomography was indicated.


METHODS
55 participants were prospectively randomised to early computed tomography (within 24 hours of admission) and 65 to standard practice (radiological investigations as indicated).


METHODS
Length of hospital stay, accuracy of diagnosis, and, owing to a possible effect on inpatient mortality, deaths during the study.


RESULTS
Early computed tomography reduced the length of hospital stay by 1.1 days (geometric mean 5.3 days (range 1 to 31) v 6.4 days (1 to 60)), but the difference was non-significant (95% confidence interval, 8% shorter stay to 56% longer stay, P=0.17). Early computed tomography missed significantly fewer serious diagnoses. Seven inpatients in the standard practice arm died. Only 50% (59 of 118) of diagnoses on admission were correct at follow up at 6 months, but this improved to 76% (90) of diagnoses after 24 hours.


CONCLUSIONS
Early abdominopelvic computed tomography for acute abdominal pain may reduce mortality and length of hospital stay. It can also identify unforeseen conditions and potentially serious complications.
Ng
Chaan S
CS
Department of Radiology, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 2QQ. cng@mdanderson.org
Watson
Christopher J E
CJ
Palmer
Christopher R
CR
See
Teik Choon
TC
Beharry
Nigel A
NA
Housden
Barbara A
BA
Bradley
J Andrew
JA
Dixon
Adrian K
AK
D015746:Abdominal Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D000328:Adult; D000368:Aged; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards