Benefit of follow-up CT in emergency department patients with persistent non-traumatic abdominal pain.
To determine the benefit of a short-term follow-up abdominopelvic computed tomography (APCT) examination among emergency department (ED) patients with persistent abdominal pain and an initially negative CT. During a 5-year period from January 2004 to December 2008, our institution's radiology department performed approximately 56,000 APCTs examinations in the ED. Sixty-eight percent of the APCT examinations used intravenous contrast. Nine hundred fifty-seven patients received two APCTs within 1 week for non-traumatic abdominal pain in the ED. Sixty-four patients with initially negative APCTs presented to the ED within 1 week with persistent abdominal pain and received follow-up APCT imaging. The mean follow-up period was 2.6 days. The mean interval period in which the second APCT yielded a positive result was 2.0 days. Seventy-five percent of follow-up examinations were performed with intravenous contrast. Twenty-three percent of patients had positive findings on the follow-up examination. Seventy-three percent of the follow-up positive findings were referable to bowel pathology. The cause of abdominal pain remained elusive at 1 week in 23% of patients. Short-term follow-up APCT examinations in patients with persistent, unexplained abdominal pain may be of benefit if the second APCT is performed with intravenous contrast in patients suspected of having bowel pathology.
Asrani
Ashwin V
AV
Department of Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Johnson
Jamlik-Omari F
JO
Novelline
Robert A
RA
D015746:Abdominal Pain / Q000000981:diagnostic imaging*; D003287:Contrast Media; D004636:Emergency Service, Hospital; D006801:Humans; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D003287:Contrast Media