Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Imaging strategies for detection of urgent conditions in acute abdominal pain

A study in this week's issue of the British Medical Journal investigates imaging strategies for detection of urgent conditions in patients with acute abdominal pain.

News image

Professor Stoker and colleagues from the Netherlands identified an optimal imaging strategy for the accurate detection of urgent conditions in patients with acute abdominal pain.

The research team conducted a fully paired multicenter diagnostic accuracy study with prospective data collection in emergency departments of 2 university hospitals and 4 large teaching hospitals.

Participants 1021 patients with non-traumatic abdominal pain of over 2 hours’ and under 5 days’ duration.

Exclusion criteria were discharge from the emergency department with no imaging considered warranted by the treating physician, pregnancy, and hemorrhagic shock.

All patients had plain radiographs, ultrasonography, and computed tomography after clinical and laboratory examination.

A panel of experienced physicians assigned a final diagnosis after 6 months and classified the condition as urgent or non-urgent.

The team's main outcome measures included sensitivity and specificity for urgent conditions, percentage of missed cases and false positives.
65% of patients had a final diagnosis classified as urgent
British Medical Journal

Exposure to radiation for single imaging strategies, conditional imaging strategies, and strategies driven by body mass index and age or by location of pain.

The researchers found that 65% of patients had a final diagnosis classified as urgent.

The initial clinical diagnosis resulted in many false positive urgent diagnoses, which were significantly reduced after ultrasonography or CT.

CT detected more urgent diagnoses than did ultrasonography, and sensitivity was 89% for CT and 70% for ultrasonography.

A conditional strategy with CT only after negative or inconclusive ultrasonography yielded the highest sensitivity, missing only 6% of urgent cases.

With this strategy, the team found that only 49% of patients would have CT.

Alternative strategies guided by body mass index, age, or location of the pain would all result in a loss of sensitivity.

Professor Stoker's team concludes, "Although CT is the most sensitive imaging investigation for detecting urgent conditions in patients with abdominal pain, using ultrasonography first and CT only in those with negative or inconclusive ultrasonography results in the best sensitivity and lowers exposure to radiation."

BMJ 2009: 338: b2431
06 July 2009

Go to top of page Email this page Email this page to a colleague

 30 October 2014

Advanced search
 30 October 2014 
Cirrhosis in women
 30 October 2014 
Costs in newly diagnosed patients with chronic constipation
 30 October 2014 
Constipation and colorectal cancer
 29 October 2014 
IBS in primary care
 29 October 2014 
Sensorimotor activity in functional dyspepsia
 29 October 2014 
Quality of life after infection with E. coli
 28 October 2014 
Increased bile acid synthesis in IBS-diarrhea
 28 October 2014 
Risk factor for smaller final height in Crohn's
 28 October 2014 
Successful radiofrequency ablation for Barrett’s
 27 October 2014 
Celiac disease and type 1 diabetes
 27 October 2014 
Gluten awareness among chefs
 27 October 2014 

PPI-responsive esophageal eosinophilia

 24 October 2014 
Olmesartan-associated enteropathy
 24 October 2014 
Opioid use in IBD
 24 October 2014 
NSAIDs and Barrett's risk
 23 October 2014 
Outcomes in hospitalized patients with GI bleeding
 23 October 2014 
Thiopurines and colorectal cancer risk in IBD
 23 October 2014 
Advancing the field of functional GI disorders
 22 October 2014 
Early-TIPSS placement prevents rebleeding
 22 October 2014 
Liver fibrosis prognostic biomarkers in type-2 diabetes
 22 October 2014 
H pylori eradication with multiple drug resistance
 21 October 2014 
Alcohol and Barrett's
 21 October 2014 
Scoring systems for critically ill cirrhotic patients
 21 October 2014 
Aspirin and NAFLD
 20 October 2014 
Drug resistant H pylori eradication
 20 October 2014 
Adalimumab in secondary loss of response in Crohn's
 20 October 2014 
Omega-3 and colorectal cancer
 17 October 2014 
Colorectal testing utilization
 17 October 2014 
Tumor necrosis factor-alpha inhibitors and pregnancy in IBD
 17 October 2014 
Fecal microbiota composition in postinfectious IBS
 16 October 2014 
Risk of Barrett's esophagus
 16 October 2014 
Aspirin tablets and colorectal tumours
 16 October 2014 
Economic impact of IBS
 15 October 2014 
Preparation for surgery in Crohn's
 15 October 2014 
Achieving competency at colonoscopy
 15 October 2014 
Bowel preparations
 14 October 2014 
Colorectal testing utilization in commercially insured US adults
 14 October 2014 
Sustained response to infliximab
 14 October 2014 
IBD management during pregnancy
 13 October 2014 
Predicting PPI response in GERD-related cough
 13 October 2014 
Probiotics in IBS
 13 October 2014 
Use of azathioprine in IBD
 10 October 2014 
Liver injury from herbals and dietary supplements
 10 October 2014 
NAFLD in the Veterans Administration population
 10 October 2014 
Predictors for cecal insertion time
 09 October 2014 
Methotrexate-related liver disease and metabolic syndrome
 09 October 2014 
Biomarkers of acetaminophen overdose patients
 09 October 2014 
Postoperative adhesions in digestive surgery
 08 October 2014 
Gluten introduction in high risk children
 08 October 2014 
Vitamin D and HCC
 08 October 2014 
Feeding intervention in celiac disease infants
 07 October 2014 
Infliximab in pediatric perianal Crohn's
 07 October 2014 
Omega-3 and NAFLD
 07 October 2014 
Endoscopic submucosal dissection in the colorectum 
 06 October 2014 
Clinical indications for computed tomographic colonography
 06 October 2014 
Certolizumab pegol in the treatment of Crohn's
 06 October 2014 
Costs of telaprevir therapy for Hep C
 03 October 2014 
Depression and liver transplantation
 03 October 2014 
Orange juice intake during bowel preparation
 03 October 2014 
HCV and diabetes

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us