Brief Reports
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2005; 11(13): 1981-1986
Published online Apr 7, 2005. doi: 10.3748/wjg.v11.i13.1981
A prospective study assessing the efficacy of abdominal computed tomography scan without bowel preparation in diagnosing intestinal wall and luminal lesions in patients presenting to the emergency room with abdominal complaints
Michal Mizrahi, Yoav Mintz, Avraham Rivkind, David Kisselgoff, Eugene Libson, Mayer Brezis, Eran Goldin, Oren Shibolet
Michal Mizrahi, Eran Goldin, Oren Shibolet, Gastroenterology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
Yoav Mintz, Avraham Rivkind, Department of General Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
David Kisselgoff, Eugene Libson, Department of Radiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
Mayer Brezis, School of Public Health, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
Author contributions: All authors contributed equally to the work.
Correspondence to: Oren Shibolet MD., Gastroenterology Unit, Division of Medicine Hadassah-Hebrew University Medical Center, Jerusalem, Israel. shibolet@hadassah.org.il
Telephone: +972-2-6778253
Received: September 23, 2004
Revised: September 24, 2004
Accepted: November 4, 2004
Published online: April 7, 2005
Abstract

AIM: To evaluate the positive predictive value of abdominal non-prepared computed tomography (CT) for diagnosing intestinal lumen or wall lesions in patients presenting to the emergency room (ER) with abdominal complaints.

METHODS: For 1-year we prospectively evaluated all ER patients hospitalized after abdominal CT scan detected either intraluminal or intestinal wall lesions. These patients underwent colonoscopy serving as gold standard. Patients with prior abdominal pathology or CT findings of appendicitis or diverticulitis were excluded.

RESULTS: Five hundred and sixty-eight abdominopelvic CT scans were performed in the ER, 96 had positive colonic findings. Sixty-two patients were excluded, 46 because of diverticulitis or appendicitis, 16 because of prior abdominal pathology. Of the remaining 34 patients, 14 did not undergo colonoscopy during hospitalization. Twenty eligible patients were included in the study. The positive predictive value of the CT scans performed in the ER was calculated to be 45% (95% CI 25-67).

CONCLUSION: CT findings correlated with colonoscopic findings only in approximately half of the cases. Relying on non-prepared CT scan findings in planning patient management and colonoscopy may lead to unnecessary diagnostic work-ups.

Keywords: Abdominal computed tomography; Intestinal lesions; Emergency room