Bhangu, Aneel and Richardson, Charlotte and Winter, Hannah and Bleetman, Anthony (2010) Value of initial radiological investigations in patients admitted to hospital with appendicitis, acute gallbladder disease or acute pancreatitis. Emergency medicine journal : EMJ, 27 (10). pp. 754-7. ISSN 1472-0213. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IdsFull text not available from this repository.
To determine the value of abdominal radiography (AXR) for investigating patients attending hospital with a first episode of appendicitis (requiring appendicectomy), acute gallbladder disease or acute pancreatitis, and to identify if early (within 18 h) ultrasound or CT scanning reduces the use of AXR. Setting Two acute teaching hospitals during August-September 2008 and February-March 2009.
Audit of 355 patients (179 patients (50%) who underwent appendicectomy, 128 (36%) admitted with acute gallbladder disease and 48 (14%) with acute pancreatitis).
AXR was performed in 53 patients (30%) who underwent appendicectomy, 73 (57%) with acute gallstone disease and 38 (78%) with acute pancreatitis. The useful abnormality pick-up rate was low; 9% (n=5), 5% (n=4) and 0% (n=0), respectively. When used, ultrasound confirmed the diagnosis in 84% (140/166) and CT scanning (either after AXR or as first line) in 97% (34/35). 42 patients underwent early ultrasound (n=27) or CT scanning (n=15), which together reduced the rate of AXR usage by 34% (14/42 early vs 107/159 delayed, p<0.001).
AXR does not aid diagnosis of these conditions but is still performed. Early ultrasound or CT scanning reduces the use of AXR and are more sensitive; methods of providing these should be explored.
|Additional Information:||This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids|
|Subjects:||WN Medical imaging. Radiology|
|Divisions:||Clinical Support > Radiology
Emergency Services > Acute Medicine and AMU
Planned IP Care > Gastroentrology
|Depositing User:||Mr Philip O'Reilly|
|Date Deposited:||04 Jul 2014 10:29|
|Last Modified:||04 Jul 2014 10:29|
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