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

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.

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.

We studied 137 patients: age 58.1 +/- 16.1 years (mean +/- SD), 80 (58.4%) females. Fifty (36.5%) patients had > or =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 > or =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.

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.