Computed tomography of the acute abdomen in patients with atrial fibrillation

Stephen J. Hunt, Fergus V. Coakley, Emily M. Webb, Antonio C. Westphalen, Liina Poder, Benjamin M. Yeh

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

OBJECTIVE: To investigate the frequency and basis of clinically relevant computed tomographic (CT) findings in patients with atrial fibrillation and acute abdominal pain. MATERIALS AND METHODS: We retrospectively identified 30 patients with atrial fibrillation referred for enhanced (n = 26) or unenhanced (n = 4) abdominal CT from our emergency department because of acute nontraumatic abdominal pain. All CT images were independently reviewed by a single reader who evaluated the studies for findings that might explain acute pain. Results were correlated with laboratory and surgical findings, clinical course and outcome, and final diagnosis. RESULTS: Eleven (37%) of the 30 patients had CT findings for abdominal pain that related to atrial fibrillation, including end-organ ischemia or infarction (n = 8, 27%) and spontaneous hemorrhage presumably related to anticoagulation (n = 3, 10%). Of the remaining patients, 5 (17%) had nonatrial fibrillation-related CT findings for abdominal pain, and 14 (47%) had no cause for abdominal pain found at CT. CONCLUSIONS: Patients with atrial fibrillation who present to CT with acute abdominal pain have a high likelihood of being found with abdominal pathology relating to their atrial fibrillation, such as arterial embolus or hemorrhage, and a lower likelihood of having more typical causes for abdominal pain. Increased awareness of the high likelihood of atrial fibrillation-related causes for abdominal pain may improve diagnoses and triage for this special and difficult population.

Original languageEnglish (US)
Pages (from-to)280-285
Number of pages6
JournalJournal of Computer Assisted Tomography
Volume33
Issue number2
DOIs
StatePublished - Mar 1 2009

Keywords

  • Acute abdomen
  • Atrial fibrillation
  • CT
  • Emergency imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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