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Imaging (e.g., ultrasonography [US] and computed tomography [CT]) in patients with acute abdominal pain lowers the number of missed diagnoses but is costly. Furthermore, CT exposes patients to radiation. In this prospective, multicenter Dutch study that involved 1021 adults with nontraumatic abdominal pain of 2 hours' to 5 days' duration, investigators sought to determine an optimal imaging strategy for detecting urgent conditions (i.e., those for which treatment was needed within 24 hours).
All patients underwent clinical examinations, laboratory tests, and plain x-rays; afterward, a diagnosis (urgent or nonurgent) was recorded. Next, CT and US were performed, and diagnoses were recorded again. (The radiologist who read a given imaging stud…