Multicenter Cooperative Collaborative Action Research Study
in the Philippines


Reynaldo O. Joson, MD, MHA, MHPEd, MS Surg
Program Director

Identified Problem

Is a recumbent plain abdominal x-ray (without an upright film) sufficient in the evaluation of patients with acute intestinal obstruction?


AJR Am J Roentgenol 1986 Sep;147(3):501-3

Plain film evaluation of patients with abdominal pain: are three radiographs necessary?

Mirvis SE, Young JW, Keramati B, McCrea ES, Tarr R.


Current recommendations for the plain radiographic evaluation of abdominal pain suggest a minimum three-film series including an erect and supine abdominal view and an erect chest study. Three film radiographic abdominal "series" were obtained in 252 consecutive emergency-room patients who presented with abdominal pain. The views were analyzed independently for their relative diagnostic value. Radiologic pathologic findings were present in 20% of the abdominal films and in 13% of the chest radiographs. The supine abdominal view and the erect chest study diagnosed normality or abnormality in 98% of these patients. The elimination of the erect abdominal view from the routine abdominal series could result in financial savings, decreased radiation exposure, and a more efficient use of technician time, without significant loss of diagnostic information.