IMPACT OF CT ON DIAGNOSIS AND MANAGEMENT OF ACUTE ABDOMEN IN PATIENTSINITIALLY TREATED WITHOUT SURGERY

OBJECTIVE. The purpose of this study was to evaluate the effect of CT on the diagnosis and management of acute abdominal pain in patients wh o did not undergo surgery and to determine what population of patients would profit most from CT examination. MATERIALS AND METHODS. Clinica l data and CT reports of 91 patients with acute abdomen (41 men and 50 women, 22-96 years old) were analyzed retrospectively The accuracies of clinical evaluation and CT in revealing the cause of acute abdomen were compared, and the effect of CT on patient management was assessed . Analysis included the entire population of patients and these subgro ups: (1) patients who had symptoms for fewer than 24 hr versus patient s who had symptoms for 24 hr or more and (2) patients who had a histor y of abdominal diseases versus patients who had no such history. RESUL TS. Twenty-nine patients had signs or symptoms for fewer than 24 hr, a nd 62 patients had signs or symptoms for 24 hr or more. Fifty-nine pat ients had a history of abdominal disease, and 32, had no history of ab dominal disease. In the entire population of patients, CT was superior to clinical evaluation for diagnosing the cause of acute abdomen (sen sitivity was 90% for CT and 76% for clinical evaluation, p < .0005). M anagement was changed after CT in 25 patients (p < .0005). Similar dif ferences were observed in the subgroups of patients with signs and sym ptoms for fewer than 24 hr, patients with signs and symptoms for 24 hr or more, and patients with no history of abdominal disease (p < .05). In the subgroup of patients with a history of abdominal disease, the differences between clinical evaluation and CT were not statistically significant. CONCLUSION. CT is an excellent examination technique for patients with acute abdomen, regardless of the duration of signs and s ymptoms. CT is particularly useful in defining the cause and therapeut ic strategy in patients with acute abdomen who have no history of abdo minal disease.