PubMed Nucleotide Protein Genome Structure PopSet Taxonomy OMIM Books
 Search for
  Limits Preview/Index History Clipboard Details    
About Entrez
spacer gif
back to About Entrez
back to About Entrez

Text Version

Entrez PubMed
Help | FAQ

PubMed Services
Journal Browser
MeSH Browser
Single Citation Matcher
Batch Citation Matcher
Clinical Queries

Related Resources
Order Documents
NLM Gateway
Consumer Health
Clinical Alerts
PubMed Central

Privacy Policy


1: Eur J Surg 1998 Oct;164(10):777-84 Related Articles, Books, LinkOut
Click here to read 
Simple data from history and physical examination help to exclude bowel obstruction and to avoid radiographic studies in patients with acute abdominal pain.

Bohner H, Yang Q, Franke C, Verreet PR, Ohmann C.

Department of General Surgery and Traumatology, Heinrich-Heine-Universitat, Dusseldorf, Germany.

OBJECTIVE: To assess the value of plain abdominal radiographs and of data from the medical history and physical examination in the diagnosis of acute abdominal pain in general and of bowel obstruction in particular. DESIGN: Prospective study. SETTING: 4 university and 2 community hospitals, Germany. SUBJECTS: 1254 patients with acute abdominal pain lasting less than 7 days, and with no history of abdominal injury including surgery. INTERVENTIONS: Standardised and structured medical history and physical examination, study of results of plain abdominal radiographs. MAIN OUTCOME MEASURES: Positive predictive value and sensitivity of clinical variables and abdominal film with respect to the diagnosis at discharge. RESULTS: 48 patients (3.8%) had bowel obstruction. 704 patients (56.1%) had plain abdominal films taken at the time of initial presentation. 111 studies (15.8%) showed important findings leading to diagnosis or immediate treatment, 455 (64.7%) showed unimportant or no findings. In 138 (19.6%) results of films were not reported. 16 of 45 single variables were of help in diagnosing bowel obstruction. The six with the highest sensitivity were distended abdomen, increased bowel sounds, history of constipation, previous abdominal surgery, age over 50, and vomiting. If only patients presenting with any two of these symptoms had had radiographs taken, 300 (42.6%) could have been avoided without loss in diagnostic accuracy. CONCLUSION: A considerable number of plain abdominal films taken for patients with acute abdominal pain could be avoided by focusing on clinical variables relevant to the diagnosis of bowel obstruction.

PMID: 9840308 [PubMed - indexed for MEDLINE]