Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2002 Dec 14;325(7377):1387.
doi: 10.1136/bmj.325.7377.1387.

Evaluation of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause: prospective randomised study

Chaan S Ng  1 , Christopher J E Watson, Christopher R Palmer, Teik Choon See, Nigel A Beharry, Barbara A Housden, J Andrew Bradley, Adrian K Dixon
Affiliations
Clinical Trial

Evaluation of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause: prospective randomised study

Chaan S Ng et al. BMJ. .

Abstract

Objectives: To evaluate the impact of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause on length of hospital stay and accuracy of diagnosis.

Design: Randomised, prospective controlled trial.

Setting: Teaching hospital in England.

Participants: 120 patients admitted with acute abdominal pain for which no immediate surgical intervention or computed tomography was indicated.

Intervention: 55 participants were prospectively randomised to early computed tomography (within 24 hours of admission) and 65 to standard practice (radiological investigations as indicated).

Main outcome measures: Length of hospital stay, accuracy of diagnosis, and, owing to a possible effect on inpatient mortality, deaths during the study.

Results: Early computed tomography reduced the length of hospital stay by 1.1 days (geometric mean 5.3 days (range 1 to 31) v 6.4 days (1 to 60)), but the difference was non-significant (95% confidence interval, 8% shorter stay to 56% longer stay, P=0.17). Early computed tomography missed significantly fewer serious diagnoses. Seven inpatients in the standard practice arm died. Only 50% (59 of 118) of diagnoses on admission were correct at follow up at 6 months, but this improved to 76% (90) of diagnoses after 24 hours.

Conclusions: Early abdominopelvic computed tomography for acute abdominal pain may reduce mortality and length of hospital stay. It can also identify unforeseen conditions and potentially serious complications.

PubMed Disclaimer

Figures

Figure
Figure
Flow of patients through trial. *Number of admitting diagnoses correct at follow up; †number of diagnoses at 24 hours correct at follow up
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Taourel P, Baron MP, Pradel J, Fabre JM, Seneterre E, Bruel JM. Acute abdomen of unknown origin: impact of CT on diagnosis and management. Gastrointest Radiol. 1992;17:287–291. - PubMed
    1. Siewert B, Raptopoulos V, Mueller MF, Rosen MP, Steer M. Impact of CT on diagnosis and management of acute abdomen in patients initially treated without surgery. Am J Roentgenol. 1997;168:173–178. - PubMed
    1. Rosen MP, Sands DZ, Longmaid HE, III, Reynolds KF, Wagner M, Raptopoulos V. Impact of abdominal CT on the management of patients presenting to the emergency department with acute abdominal pain. Am J Roentgenol. 2000;174:1391–1396. - PubMed
    1. Stapakis JC, Thickman D. Diagnosis of pneumoperitoneum: abdominal CT vs upright chest film. J Comput Assist Tomogr. 1992;16:713–716. - PubMed
    1. Puylaert JBCM, van der Zant FM, Rijke AM. Sonography and the acute abdomen. Am J Roentgenol. 1997;168:179–186. - PubMed

Publication types