Plain film evaluation of patients with abdominal pain: are three radiographs necessary?

AJR Am J Roentgenol. 1986 Sep;147(3):501-3. doi: 10.2214/ajr.147.3.501.


Current recommendations for the plain radiographic evaluation of abdominal pain suggest a minimum three-film series including an erect and supine abdominal view and an erect chest study. Three film radiographic abdominal "series" were obtained in 252 consecutive emergency-room patients who presented with abdominal pain. The views were analyzed independently for their relative diagnostic value. Radiologic pathologic findings were present in 20% of the abdominal films and in 13% of the chest radiographs. The supine abdominal view and the erect chest study diagnosed normality or abnormality in 98% of these patients. The elimination of the erect abdominal view from the routine abdominal series could result in financial savings, decreased radiation exposure, and a more efficient use of technician time, without significant loss of diagnostic information.

MeSH terms

  • Abdomen, Acute / diagnostic imaging*
  • Humans
  • Intestinal Obstruction / diagnostic imaging
  • Methods
  • Pain / etiology*
  • Radiography, Abdominal*
  • Radiography, Thoracic