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Inicio Radiología (English Edition) Routine abdominal X-rays in the emergency department: A thing of the past?
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Vol. 57. Issue 5.
Pages 380-390 (September - October 2015)
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Vol. 57. Issue 5.
Pages 380-390 (September - October 2015)
Update in Radiology
DOI: 10.1016/j.rxeng.2015.08.001
Routine abdominal X-rays in the emergency department: A thing of the past?
Radiografía del abdomen en Urgencias. ¿Una exploración para el recuerdo?
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J.M. Artigas Martína,
Corresponding author
jmartigasm@gmail.com

Corresponding author.
, M. Martí de Graciab, C. Rodríguez Torresc, D. Marquina Martínezc, P. Parrilla Herranzd
a Radiología de Urgencias, Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, Spain
b Radiología de Urgencias, Servicio de Radiodiagnóstico, Hospital Universitario La Paz, Madrid, Spain
c Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, Spain
d Servicio de Urgencias, Hospital Universitario Miguel Servet, Zaragoza, Spain
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Table 1. Problems derived from using abdomen radiographies in the emergency room.
Table 2. Proposal of indications for abdomen radiographies in the emergency room.
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Abstract

The large number of abdominal X-ray examinations done in the emergency department is striking considering the scant diagnostic yield of this imaging test in urgent disease. Most of these examinations have normal or nonspecific findings, bringing into question the appropriateness of these examinations. Abdominal X-ray examinations are usually considered a routine procedure or even a “defensive” screening tool, whose real usefulness is unknown. For more than 30 years, the scientific literature has been recommending a reduction in both the number of examinations and the number of projections obtained in each examination to reduce the dose of radiation, unnecessary inconvenience for patients, and costs.

Radiologists and clinicians need to know the important limitations of abdominal X-rays in the diagnostic management of acute abdomen and restrict the use of this technique accordingly. This requires the correct clinical selection of patients that can benefit from this examination, which would allow better use of alternative techniques with better diagnostic yield, such as ultrasonography or computed tomography.

Keywords:
Abdomen
Plain films
Emergencies
Diagnosis
Indications
Appropriateness
Resumen

La escasa rentabilidad diagnóstica de la radiografía de abdomen en patología urgente contrasta con el elevado número de exploraciones que se realizan. La mayoría arroja hallazgos normales o inespecíficos, lo que cuestiona la idoneidad de su indicación. Suele considerarse un procedimiento rutinario o incluso una herramienta “defensiva”de cribado, cuya utilidad real se desconoce. Desde hace más de 30 años, se recomienda en la literatura científica reducir tanto el número de exploraciones como el de proyecciones realizadas, en aras a disminuir dosis de radiación, molestias innecesarias para los pacientes y costes.

Radiólogos y clínicos deben conocer las importantes limitaciones de la radiografía de abdomen en el manejo diagnóstico de la patología abdominal aguda y restringir su empleo. Para ello, es imprescindible una adecuada selección clínica de los pacientes candidatos a estudio de imagen, que permite un empleo ágil de técnicas alternativas más rentables como la ecografía o la tomografía computarizada.

Palabras clave:
Abdomen
Radiografía
Urgencias
Diagnóstico
Indicaciones
Adecuación

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