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Plain abdominal radiographs in acute medical emergencies: an abused investigation?

¹ Department of Medicine for the Elderly, Wirral Hospitals Trust, Arrowe Park Hospital, Upton, Wirral
² Department of Radiology, Wirral Hospitals Trust, Arrowe Park Hospital, Upton, Wirral

Correspondence to:
Correspondence to:
Dr Sylvia Feyler, Clatterbridge Centre for Oncology, Clatterbridge Hospital, Bebington, Wirral, CH63 4JY, UK;
sylviafeyler{at}hotmail.com

Plain abdominal radiographs are commonly requested for acute medical emergencies on patients with non-specific abdominal symptoms and signs. In this study 131 plain abdominal radiographs performed on the day of admission were prospectively analysed. In only 16 cases (12%) the reasons for requests conformed to the recommended guidelines by the Royal College of Radiologists. The reason for the request was stated in the case notes in only three cases. In 62 cases (47%), there was no comment made on the film by the requesting clinician. There was a discrepancy in the interpretation of the radiograph between the clinician and the radiologist in 31 cases (24%). The clinical management was influenced by plain abdominal radiographs in only nine cases (7%). The majority of plain abdominal radiographs requested on acute medical emergencies is inappropriate. There is a need to ensure guidelines are followed to prevent unnecessary exposure of patients to radiation as well as preventing expenditure on irrelevant investigations.

Keywords: abdominal radiography; audit; guidelines

Abbreviations: PRHO, preregistration house officer; SHO, senior house officer

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