title: Incidental findings detected on emergency abdominal CT scans: a 1-year review.
abstract: BACKGROUND
  In recent years, there has been a substantial rise in the use of computed tomography (CT) in the emergency medicine setting. Accordingly, with increased CT usage there has been an upsurge in incidental pathology detection.
  
  
  METHODS
  A retrospective review of all emergency CT abdominal scans performed at a university teaching hospital was examined. The frequency of incidental findings, their clinical significance and workload effect for the radiology department was assessed.
  
  
  RESULTS
  1155 patients had an emergency abdominal CT scan of which 700 had incidental findings detected. Of the incidental findings, 143 were deemed indeterminate requiring urgent investigations. Twenty-four occult neoplasms were confirmed subsequently. Additionally, 259 patients were recommended for additional diagnostics. The cumulative effect of the initial emergency abdominal CT was 15,015 relative value units (RVU). Subsequent imaging of incidental findings resulted in another 1674 RVU workload for radiology.
  
  
  CONCLUSIONS
  Incidental findings cause considerable debate and concern over which patients require significant follow-up, investigations, and/or surveillance. This exerts significant pressures on sub-specialties for their expert input, with increased workload and implications on healthcare service provision.
authors.affiliation: Department of Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland, kellym11@tcd.ie.
authors.forename: M E
authors.initials: ME
authors.lastname: Kelly
authors.forename: A
authors.initials: A
authors.lastname: Heeney
authors.forename: C E
authors.initials: CE
authors.lastname: Redmond
authors.forename: J
authors.initials: J
authors.lastname: Costelloe
authors.forename: G J
authors.initials: GJ
authors.lastname: Nason
authors.forename: J
authors.initials: J
authors.lastname: Ryan
authors.forename: D
authors.initials: D
authors.lastname: Brophy
authors.forename: D C
authors.initials: DC
authors.lastname: Winter
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016526:Workload; D055815:Young Adult