Evaluation of the role of plain x-ray in the diagnosis of acute abdomen

ABSTRACT

Acute abdomen in still one of the difficult problems that face the surgeons either in the diagnosis or management. In this study plain abdominal radiographs were carried out on 50 patients, excluding pregnant women, suffering from acute abdominal conditions, both traumatic and non-traumatic. The radiologist's report was assessed with the final diagnosis proved by follow up of the patient during his admission. The plain abdominal radiographs were helpful in 46% of cases. It was confirmatory to provisional diagnosis in 34% and diagnostic in 12% where provisional diagnosis was changed. The yield rate of 46% from a single investigation is considered very high if compared to the positive yield of routine biochemical investigation, which is only 18%. The stated management was changed after X-rays in 10% of cases, 4% from surgical to conservative and 6% from conservative to surgical management. It was concluded that, plain X-ray of the abdomen should become a routing investigation in the acute abdominal conditions. Erect film is more useful, but supine one is more comfortable and easier. Plain X-ray is more helpful in acute abdomen due to pathological conditions other than trauma