Abdominal Radiography in the Emergency Department – Routine Practice or Real Necessity?

Abstract

Introduction: Abdominal pain is a common cause of admission in the emergency department, often posing a diagnostic challenge due to its nonspecific nature and wide etiological spectrum. Despite the widespread use of abdominal radiography in the evaluation of acute abdominal pain, its low sensitivity and limited diagnostic value restrict its clinical utility, potentially delaying treatment. This study evaluates the appropriateness of abdominal radiograph in an emergency department, based on the guidelines of the Royal College of Radiologists.
Material and methods: A retrospective analysis was conducted on abdominal radiograph requests made in the emergency department, considering the following variables: patient gender and age, presence or absence of clinical information, establishment of diagnostic hypothesis, exam appropriateness, type of projection performed, projection appropriateness, additional radiological examinations performed, and type of additional examination performed.
Results: Of the 2002 requests, 47,1% included clinical information, while 52,9% did not. Among the 943 requests with clinical information, a diagnostic hypothesis could be identified in 19,4% of the cases. Of the requests that included clinical information, 16,7% were deemed appropriate.
Conclusion: This study revealed an inappropriate use of abdominal radiography, contributing to avoidable patient radiation exposure. The findings reinforce the need for clear guidelines and strategies to encourage a more selective use of this exam, reducing unnecessary radiation exposure and optimizing health resources.