title: The need for surgery in acute abdominal pain: a randomized study of abdominal computed tomography.
abstract: OBJECTIVE
  To assess the need for surgical treatment in patients with acute abdominal pain in a prospective randomized study.
  
  
  METHODS
  Initially 203 patients with acute abdominal pain were randomized to the routine abdominal computed tomography CT (rCT, n=118), or selective abdominal CT group (sCT, n=85) over a period of 16 months. Ninety-three of the randomized patients (45.8%) underwent the study design and were reached for follow-up at three months.
  
  
  RESULTS
  Diagnostic accuracy improved significantly in the rCT group (p<0.001). The surgeon's assessment of the need for surgery changed more often in the rCT group than in the sCT group (78.7% vs. 46.9%, p=0.002). The confidence to treat operatively increased significantly in the rCT vs. the sCT group (65.6% vs. 40.6%, p=0.028). The rCT was the only independent parameter for the change of the assessment of surgery.
  
  
  CONCLUSIONS
  Routine CT allows for more confidence in decision making for the surgical treatment of patients with acute abdominal pain.
authors.affiliation: Department of Surgery, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Finland. petri.juvonen@kuh.fi.
authors.forename: Petri
authors.initials: P
authors.lastname: Juvonen
authors.forename: Tiina
authors.initials: T
authors.lastname: Lehtimäki
authors.forename: Matti
authors.initials: M
authors.lastname: Eskelinen
authors.forename: Imre
authors.initials: I
authors.lastname: Ilves
authors.forename: Ritva
authors.initials: R
authors.lastname: Vanninen
authors.forename: Pekka
authors.initials: P
authors.lastname: Miettinen
authors.forename: Hannu
authors.initials: H
authors.lastname: Paajanen
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards; D055815:Young Adult
keywords: Acute abdomen; decision making; diagnostic accuracy; need for surgery; randomized controlled study; routine CT; selective CT