title: Diagnostic value of plain abdominal radiographs in patients with acute abdominal pain.
abstract: OBJECTIVE
  A prospective study was performed over a 3-month period in a tertiary referral centre to evaluate the appropriateness and contribution of plain abdominal radiographs (PAR) in the diagnosis and management of adult patients presenting with acute abdominal pain.
  
  
  METHODS
  Forward stepwise logistic regression was used to examine the correlation between PAR findings and the final diagnosis. The Chi-squared test was used to determine any changes in patient management including requirement for surgical intervention based on PAR findings (p < 0.05).
  
  
  RESULTS
  Of 168 patients (246 PAR), 59 (35%) had positive findings on PAR. PAR were most sensitive in cases of intestinal obstruction (odds ratio, OR = 33.548, r = 0.561). The sensitivity was further increased if three of the following predictive signs were present: exaggerated bowel sounds (OR = 13.350, r = 0.154), abdominal distension (OR = 2.993, r = 0.234) and age over 50 years (OR = 2.301, r = 0.027). PAR were non-diagnostic in 82% of patients with acute abdominal pain (p < 0.001).
  
  
  CONCLUSIONS
  PAR do not play a major role in influencing the management of patients with acute abdominal pain without coexisting bowel obstruction.
authors.affiliation: Department of Surgery, Faculty of Medicine and Health Sciences, University Putra Malaysia, Selangor, Malaysia.
authors.forename: Subhita
authors.initials: S
authors.lastname: Prasannan
authors.forename: Tam Jenn
authors.initials: TJ
authors.lastname: Zhueng
authors.forename: Yunus A
authors.initials: YA
authors.lastname: Gul
mesh_terms: D000006:Abdomen, Acute / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D000328:Adult; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000000981:diagnostic imaging*; D011859:Radiography