Bohner et al identified clinical findings associated with significant findings on plain abdominal radiographs in a patient with acute abdominal pain. These can help to decide if radiographs are necessary or not. The authors are from Heinrich-Heine Universitat in Dusseldorf.
Patient selection: acute abdominal pain for < 7 days without history of trauma
Clinical findings:
(1) abdominal distention
(2) increased bowel sounds
(3) history of constipation
(4) history of previous abdominal surgery
(5) age > 50 years
(6) vomiting
number of clinical findings =
= SUM(findings present)
Interpertation:
• minimum number: 0
• maximum number: 6
• The authors found that performing X-rays only when >= 2 findings are present avoided loss of diagnostic accuracy. In the study population 42% of abdominal X-rays could be avoided.
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