EP 508 The Usefulness of Plain Abdominal X-rays in the Investigation of the Acute Abdomen

Aim

Plain abdominal x-rays (AXR) are used in the diagnosis of acute abdominal conditions. Rosenbaum et al in 1964 noted that only 7% of AXRs were diagnostic. Computerised Tomography (CT) scan with a sensitivity of 91.7% and specificity of 86.7% is considered the gold standard investigation for acute abdominal conditions. The RCR iRefer guidelines for plain abdominal radiography include indications like obstruction and perforation amongst others.

The aim of our study is to assess the usefulness of plain abdominal x-ray in diagnosing acute abdomen.

Method

A retrospective study looking at patients referred to the surgical service from A&E at our hospital with acute abdominal conditions over a 2-month period. We looked at patients that were investigated with both AXR and CT scan of the abdomen and correlated the findings.

Statistical analysis was done with Stata.

Results

Over August and September 2025, 301 patients with acute abdominal conditions were referred to the surgical department via A&E. Of these 33(11%) were investigated with both AXR and CT scans of the abdomen. Of the 33patients that had both AXR and CT scans, 17(51%) had x-ray findings correlating with CT findings.

Conclusion

A small number of patients received both AXR and CT scan of the abdomen. AXR findings correlated with CT abdomen findings in 51% of these patients. We conclude that AXRs should only be used in a very select small number of patients and going straight to CT scan of the abdomen would reduce time and cost of investigations.