AB129. SOH23ABS_101. The evaluation of compliance with iRefer guidelines for abdominal imaging and the discovery of new pathologic findings on the abdominal X-ray (AXR) performed

Background: Attendance of adult patients to the emergency department (ED) with acute abdominal pain is a frequent event. Abdominal X-ray (AXR) imaging is commonly the choice of investigation but previous studies have suggested that AXR plays a small role in assessment because of its low diagnostic yield and limited contribution to direct clinical decision making. As per iRefer radiology guideline, there are four indications of requesting an X-ray that are shown to be clinically relevant and thus minimizing the unnecessary radiation in non-indicated tests: Clinical suspicion of bowel obstruction, foreign body ingestion, renal colic and acute exacerbation of inflammatory bowel disease.

Methods: Retrospective data of patients who presented to the ED of South Tipperary University Hospital from October to November 2021 were collected. Data was collected through the NIMIS system.

Results: A total of 202 patients were collected. Only 51% (103/202) of the AXR done were in compliance to the guideline. Of these, only 13% had significant pathological findings.

Conclusions: Although AXR plays an important imaging tool in assessment of abdominal pain, it should be used cautiously. Junior doctors are encouraged to adhere to the guideline. If in doubt, senior advice should be taken prior to requesting AXR imaging.

Keywords: Abdomen; emergency; obstruction; foreign body; X-ray