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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.

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Correspondence to Jamlik-Omari F. Johnson.

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Asrani, A.V., Johnson, JO.F. & Novelline, R.A. Benefit of follow-up CT in emergency department patients with persistent non-traumatic abdominal pain. Emerg Radiol 18, 5–9 (2011). https://doi.org/10.1007/s10140-010-0893-8

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  • DOI: https://doi.org/10.1007/s10140-010-0893-8

Keywords

  • Computed tomography
  • Abdominal pain
  • Follow-up
  • Imaging
  • Emergency department
  • Undiagnosed pain