title: Benefit of follow-up CT in emergency department patients with persistent non-traumatic abdominal pain.
abstract: 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.
authors.affiliation: Department of Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
authors.forename: Ashwin V
authors.initials: AV
authors.lastname: Asrani
authors.forename: Jamlik-Omari F
authors.initials: JO
authors.lastname: Johnson
authors.forename: Robert A
authors.initials: RA
authors.lastname: Novelline
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging*; D003287:Contrast Media; D004636:Emergency Service, Hospital; D006801:Humans; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media