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Family Practice Advance Access published online on June 17, 2005
Family Practice, doi:10.1093/fampra/cmi039
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© The Author (2005). Published by Oxford University Press. All rights reserved.
Received May 20, 2004
Accepted April 1, 2005

Article

Results of computed tomography in family practitioners' patients with non-acute abdominal pain

Sonali S. Master 1, George F. Longstreth 1*, and Amy L. Liu 2

1 Department of Gastroenterology, Kaiser Permanente Medical Care Plan, San Diego, California, USA
2 Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, California, USA

* To whom correspondence should be addressed.
George F. Longstreth, E-mail: George.F.Longstreth{at}kp.org


  Abstract

Objectives. The utility of abdominal computerized tomography (CT) for evaluating abdominal pain in non-emergency, primary care outpatients is unknown. Family practice patients commonly report abdominal pain.

Methods. We reviewed the records of health maintenance organization primary care outpatients >2 years after they had undergone CT for abdominal pain and assessed demographic variables, clinical and laboratory data, CT findings and final diagnoses.

Results. We studied 137 patients: age 58.1 ± 16.1 years (mean ± SD), 80 (58.4%) females. Fifty (36.5%) patients had ≥1 warning clinical or laboratory feature. Positive (etiologic) and negative CT reports and unrelated and multiple CT findings occurred in 16 (11.7%), 104 (75.9%), 16 (11.7%) and 1 (0.7%) patients, respectively. Positive findings occurred in 16 (32.0%) patients with ≥1 warning feature and 1 (1.2%) patient (including the 1 patient with multiple findings) with no warning feature (P < 0.0001). One (6.3%) unrelated finding led to treatment, ovariectomy for a benign tumor. Fifty-four (39.4%) patients had a final diagnosis.

Conclusions. A majority of outpatients who had CT for abdominal pain received no diagnosis, and CT was rarely diagnostic for patients lacking a warning feature. Positive and unrelated CT findings were equally prevalent, and the latter were not beneficial.

Keywords: Abdominal pain; computed tomography.
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