Keywords:
Abdomen, Emergency, Conventional radiography, Audit and standards, Obstruction / Occlusion, Calcifications / Calculi, Foreign bodies
Authors:
Z. J. Hussain1, H. F. D'Costa2; 1Oxford/UK, 2OX3 9DU/UK
DOI:
10.1594/ecr2012/C-0877
Methods and Materials
This was a retrospective study of a one-month sample of abdominal plain films,
performed and reported in a large tertiary referral centre.
Abdominal films of all non-traumatic cases excluding patients under the age of 16 were audited.
Children were excluded as pathologies vary from those of adults and therefore pathways of investigations.
All reports included in the study were verified by a senior registrar or consultant radiologist.
A comprehensive investigation of the 304 films and the clinical request cards included the following:
- Gender,
- Age,
- Clinical details on request form,
- Clinical question justifying exposure,
- Relevant positive findings in the report and
- Full details of any further investigations.
Further investigations were only included if they were carried out within the same clinical scenario as the original plain film.
If for example,
symptoms had changed after a few days of admission,
or a patient had been re-admitted with the same symptoms,
further investigations at that time were not included in this study.
Using the information provided by the referrer,
a clinical judgement was made,
with respect to the Royal College of Radiology guidelines (2),
as to whether or not the investigation was truly appropriate.
The data was then organised according to referrer,
justification,
reported findings and further investigations.
This was subsequently analysed with a view to determining the most useful applications for the abdominal radiograph.