Plain abdominal radiography as a routine procedure for acute abdominal pain of the right lower quadrant: Prospective evaluation

The aim of this prospective study was to determine whether plain abdominal radiographs (PAX) are helpful in the management of adult patients presentin g with acute pain of the right lower quadrant (RLQ), A questionnaire was fi lled in for each patient admitted to our hospital for acute abdominal pain of the PAX, before and after PAX were obtained. The initial questionnaire i ndicated the suspected diagnosis and a provisional therapeutic option. A to tal of 104 consecutive patients were included in this study, 76 of whom und erwent surgery. The negative laparotomy rate was 22%. PAX changed the suspe cted diagnosis and management for six patients (6%), leading in one case to negative laparotomy, Of the remaining five patients, three were operated ( two for acute appendicitis and one for small bowel obstruction), and two me re treated conservatively for ureteral calculi, This prospective study seem s to demonstrate that the indiscriminate use of PAX is not helpful for most patients with acute pain of the RLQ, However, it may be performed in selec ted patients with clinically suspected small bowel obstruction or urinary s ymptoms.