Joseph Coyle, Presenter: Nothing to Disclose

Cressida Brennan, Abstract Co-Author: Nothing to Disclose

Kevin Noel O'Regan MD, Abstract Co-Author: Nothing to Disclose

Patrick Mc Laughlin MBBCh, Abstract Co-Author: Nothing to Disclose

Michael M. Maher MD, FRCR, Abstract Co-Author: Nothing to Disclose

Max Frederick Ryan MBBCh, Abstract Co-Author: Nothing to Disclose

 In this retrospective study we aimed to review all those patients who underwent CT of abdomen on presentation with acute abdomen and to then establish the value of CRP and other laboratory indices in predicting positive CT findings in the non-traumatic acute abdomen.

Abdominal CT, (n=411) examinations in patients presenting with “acute abdomen” were reviewed. 245 patients of the 411 identified met the inclusion criteria. Scans were deemed positive or negative and findings correlated with biochemical and haematological variables, including CRP. Exclusion criteria included trauma, post-operative status and malignancy. Statistical analysis was performed using SPSS (Version 14.0), using descriptive statistics and Chi squared analysis.  

 In total, 133 patients were included in the study (Age range 17-89, Mean 50.65; 68F:65M). Of the 133 abdominal CT studies, 69.9% (n=93) demonstrated positive findings. In patients with a normal CRP value (n=42), 50% had positive scan findings, including IBD (n=5), Small Bowel Obstruction (n=3), Appendicitis (n=2) and Acute Cholecystitis (n=1). This was in contrast with high CRP levels >100 (n =37), where over 81% had positive scan findings. The difference between these 2 groups did not reach statistical significance however (p=0.57). A high frequency of positive studies (>80%) was seen with; elevated Leucocyte count (86%); elevated serum Urea levels (85.2%), and combined elevated leucocyte count and CRP level (89.7%).  

 A high CRP value, either alone, or in combination with certain laboratory indices is useful in the prediction of positive abdominal CT findings in the non-traumatic acute abdomen.

The identification of a level of CRP either alone or in combination with other abnormal indices which might have a significant positive predictive value may have a role in patient selection for CT.

Coyle, J, Brennan, C, O'Regan, K, Mc Laughlin, P, Maher, M, Ryan, M, A Study of the Utility of C Reactive Protein (CRP) and Other Laboratory Indices as Predictors of Positive CT Findings in Computed Tomography of the 'Acute Abdomen'.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8014305.html