Abnormal CT findings among patients with abdominal pain in the radiology department of a tertiary care center

Abstract

Background: Abdominal pain is a common symptom in people of different ages due to various benign and life-threatening causes. Imaging studies, including computerized tomography (CT) scans, explore the clinical reasons behind this pain to prevent delayed diagnosis. Owing to abnormal findings, timely identification of the exact cause of abdominal pain is important in most diseases so treatment can be started earlier, but it has not yet been studied, making this research novel. This study was conducted to identify the prevalence of abnormal CT scan findings among referred patients with abdominal pain and to confirm or determine other diagnoses compared to other imaging modalities in the Emergency Department (ED). Methods: This observational retrospective study was conducted at the King Fahad Hospital, a tertiary hospital in Qassim. We included 2,144 patients who visited the ED and underwent abdominal CT scans between January 2021 and January 2022. Data on age, sex, CT findings, and results from other imaging modalities were collected from the Radiology Department. Results: We found that 2,144 patients referred from the ED to the Radiology Department complained of acute abdominal pain in 2021 for CT diagnosis. Approximately 28.2% of these patients had normal CT diagnoses. The average age at normal CT diagnosis was 38.6 years old. While 52% of CT diagnoses were abnormal, including obstructive ureteric stone (435, 20.3%), appendicitis (205, 9.6%), bowel obstruction (51, 2.4%), renal cancer (27, 1.3%), ovarian cancer (25, 1.2%), and obstructive bladder stone (25, 1.2%), with an average age of 40.4 years old, and 19% with accidental findings. Conclusions: Most of the cases with abdominal pain showed abnormal results in the CT scan. These results demonstrate the sole inefficiency of CT scan for the diagnosis of abdominal pain. So, clinical evaluations should be used together with abdominal ultrasonography to perform a timely and exact diagnosis.