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J R Soc Med. 1985 August; 78(8): 630–633.
PMCID: PMC1289834

Evaluation of the plain abdominal X-ray in the acute abdomen.


The prognostic value of an erect and supine abdominal X-ray was studied prospectively in 97 patients with an acute abdomen. Although 64 (66%) of the radiographs showed an abnormality, the surgical registrar altered his clinical diagnosis on only seven occasions and changed his management on four. A consultant radiologist was the most accurate at reporting the X-rays even without seeing the patient, whilst junior surgical and radiological staff were as accurate as each other. A surgical registrar, however, was more accurate than junior radiologists in making a diagnosis. The investigation was of immediate clinical value in only 4% of the patients, and its use could probably be limited without detriment to patients.

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Selected References

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  • de Lacey GJ, Wignall BK, Bradbrooke S, Reidy J, Hussain S, Cramer B. Rationalising abdominal radiography in the accident and emergency department. Clin Radiol. 1980 Jul;31(4):453–455. [PubMed]
  • Eisenberg RL, Heineken P, Hedgcock MW, Federle M, Goldberg HI. Evaluation of plain abdominal radiographs in the diagnosis of abdominal pain. Ann Intern Med. 1982 Aug;97(2):257–261. [PubMed]
  • Golberg B. Department of inappropriate investigations. Br Med J. 1977 Nov 12;2(6097):1274–1275. [PMC free article] [PubMed]
  • Lee PW. The plain X-ray in the acute abdomen: a surgeon's evaluation. Br J Surg. 1976 Oct;63(10):763–766. [PubMed]
  • McCook TA, Ravin CE, Rice RP. Abdominal radiography in the emergency department: a prospective analysis. Ann Emerg Med. 1982 Jan;11(1):7–8. [PubMed]

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