Document Detail


Computed tomography of the acute abdomen in patients with atrial fibrillation.
MedLine Citation:
PMID:  19346859     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Stephen J Hunt; Fergus V Coakley; Emily M Webb; Antonio C Westphalen; Liina Poder; Benjamin M Yeh
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of computer assisted tomography     Volume:  33     ISSN:  1532-3145     ISO Abbreviation:  J Comput Assist Tomogr     Publication Date:    2009 Mar-Apr
Date Detail:
Created Date:  2009-04-06     Completed Date:  2009-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7703942     Medline TA:  J Comput Assist Tomogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  280-5     Citation Subset:  IM    
Affiliation:
Department of Radiology, University of California-San Francisco, San Francisco, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdomen, Acute / etiology*,  radiography*
Adult
Aged
Aged, 80 and over
Atrial Fibrillation / complications*
Contrast Media / diagnostic use
False Negative Reactions
False Positive Reactions
Female
Gastrointestinal Hemorrhage / etiology,  radiography
Humans
Infarction / etiology,  radiography
Intestines / blood supply
Ischemia / etiology,  radiography
Male
Middle Aged
Radiographic Image Enhancement
Retrospective Studies
Tomography, X-Ray Computed
Grant Support
ID/Acronym/Agency:
1 T32EB001631-01A1/EB/NIBIB NIH HHS
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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