{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:40:29Z","timestamp":1747183229321,"version":"3.40.5"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T00:00:00Z","timestamp":1683072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The COVID\u201019 pandemic led to a global shortage of iodinated contrast media (ICM) in early 2022. ICM is used in more than half of the computed tomography of the abdomen and pelvis (CTAP) performed to diagnose an acute abdomen (AA). In response to the shortage, the RANZCR published contrast\u2010conserving recommendations. This study aimed to compare AA diagnostic outcomes of non\u2010contrast CTs performed before and during the shortage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single\u2010centre retrospective observational cohort study of all adult patients presenting with an AA who underwent a CTAP was conducted during the contrast shortage period from May to July 2022. The pre\u2010shortage control comparison group was from January to March 2022; key demographics, imaging modality indication and diagnostic outcomes were collected and analysed using SPSS v27.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine hundred and sixty\u2010two cases met the inclusion criteria, of which <jats:italic>n<\/jats:italic>\u2009=\u2009502, 52.2% were in the shortage period group. There was a significant increase of 464% in the number of non\u2010contrast CTAPs performed during the shortage period (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). For the six AA pathologies, only <jats:italic>n<\/jats:italic>\u2009=\u20093, 1.8% of non\u2010contrast CTAPs had equivocal findings requiring further imaging with a contrast CTAP. Of the total CTs performed, <jats:italic>n<\/jats:italic>\u2009=\u2009464, 48.2% were negative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study showed that when non\u2010contrast CTs are selected appropriately, they appear to be non\u2010inferior to contrast\u2010enhanced CTAPs in diagnosing acute appendicitis, colitis, diverticulitis, hernia, collection, and obstruction. This study highlights the need for further research into utilizing non\u2010contrast scans for assessing the AA to minimize contrast\u2010associated complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.18463","type":"journal-article","created":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T05:17:00Z","timestamp":1683177420000},"page":"1599-1603","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Diagnosing the acute abdomen during a global contrast shortage: a single centre experience"],"prefix":"10.1111","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7041-7782","authenticated-orcid":false,"given":"Katie","family":"Wang","sequence":"first","affiliation":[{"name":"General Surgery Royal Perth Hospital  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitchell","family":"Atkinson","sequence":"additional","affiliation":[{"name":"General Surgery Royal Perth Hospital  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0491-4283","authenticated-orcid":false,"given":"Munyaradzi G.","family":"Nyandoro","sequence":"additional","affiliation":[{"name":"General Surgery Royal Perth Hospital  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten","family":"Biddle","sequence":"additional","affiliation":[{"name":"General Surgery Royal Perth Hospital  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1474-5965","authenticated-orcid":false,"given":"Leslie Zhi Wei","family":"Lew","sequence":"additional","affiliation":[{"name":"General Surgery Royal Perth Hospital  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dieter G.","family":"Weber","sequence":"additional","affiliation":[{"name":"General Surgery Royal Perth Hospital  Perth Western Australia Australia"},{"name":"The University of Western Australia  Crawley Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000371583"},{"key":"e_1_2_9_3_1","unstructured":"The Royal Australian and New Zealand College of Radiologists.RANZCR statement on iodinated contrast media shortage[press release] 2022.https:\/\/www.ranzcr.com\/whats-on\/news-media\/560-iodinated-contrast-media-shortage-statement"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.22.27969"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2431"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.325.7377.1387"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10140-006-0493-9"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.6.665"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra072149"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2017152852"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1067\/j.cpradiol.2014.05.001"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcma.2013.01.007"},{"key":"e_1_2_9_13_1","first-page":"1537","article-title":"Diagnosis of acute abdominal pain in older patients","volume":"74","author":"Lyon C","year":"2006","journal-title":"Am. 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