Plain abdomen radiographs: the right view?

Abstract

Plain abdomen radiographs (PAR) have limited use in the setting of the emergency department. We conducted this study to look at the appropriateness of requests and its utilization in our emergency department. We conducted a retrospective analysis of scanned emergency department notes between the period of December 2005 and February 2006 (3 months). Those cases with PAR requested by an emergency department doctor were recruited in this study. The documented history, examination, and provisional diagnosis in the case notes were reviewed to look at the appropriateness of the indications for requests. Only 67% (50 of 75) of the requests were appropriate according to the Royal College of Radiologists guidelines with bowel obstruction/paralytic ileus, renal colic and foreign body ingestion being the common presentations. Thirty three percent (25 of 75) (95% confidence interval: 24-45) of the requests were inappropriate and could have been avoided by referring to the aforementioned guidelines. We recommend implementing strict local protocols and guidelines for requesting PAR to reduce inappropriate requests. We also recommend staff education and awareness programs for reducing the over-utilizing of PAR.