Role of plain abdominal radiography in the evaluation of acute abdominal pain

Abstract

In differential diagnosis of acute abdominal pain which is one of the most commonly encountered situations in emergency departments, data in the literature shows variability with regard to diagnostic efficiency of plain abdominal radiography. Radiation dose should be considered especially in pediatric patients and in patients in whom multiple radiographies are required, because radiation dose of plain abdominal radiography (0.7 millisievert) is much higher than that of chest radiography (0.01–0.02 millisievert). In emergency departments, plain radiographies are not usually evaluated by radiologists, by that way; evaluation of radiographies with priority of clinical diagnosis may cause false positive and false negative results. Plain abdominal radiographies have higher diagnostic efficiency especially for intestinal obstruction and gastrointestinal perforation among the other abdominal emergencies. Therefore, plain abdominal radiography should be the first imaging modality in patients with clinical and physical findings compatible with intestinal obstruction and gastrointestinal perforation. However, use of plain abdominal radiography in other acute abdominal pathologies including acute appendicitis does not appear to be appropriate because of inadequate diagnostic efficiency and risk of radiation exposure.