Discrepancy Rates in Acute Abdominal CT: An Audit of In-House and Remote Reporting Compared to Intraoperative Laparoscopic and Laparotomy Findings

Introduction: Non-traumatic abdominal pain is a common emergency presentation frequently managed by general surgeons. Abdominopelvic computed tomography (CT) scans are the most popular imaging modality in this context. In many hospitals, the rising demand for urgent and emergent scans out-of-hours has necessitated the outsourcing of this service to teleradiology companies, whereby reports are generated at sites remote from the image acquisition. The primary aim of this study was to determine the discrepancy rates of preoperative CT imaging by source (teleradiology compared to in-house).

Methods: This was a retrospective monocentric study conducted at a busy district general hospital over a seven-month period. Patient demographic data, operative notes, and radiology reports (by source) were collated for all patients aged ≥16 years presenting with atraumatic abdominal pain who underwent abdominopelvic CT with subsequent surgical intervention (laparoscopy and/or laparotomy).

Results: Seventy-one patients were identified by initial screening, and 10 patients (11 scans) met the criteria for a "major" discrepancy. Overall discrepancy rates were calculated at 5.6% for scans reported off-site compared to 9.9% for reports generated by in-house radiologists.

Conclusion: This study demonstrated lower discrepancy rates in scans reported remotely and can be used as the catalyst for improving aspects of in-house CT reporting.