Background
The role of computed tomography (CT) in acute abdominal illnesses has increased significantly in recent years. However, there remains a considerable variation in indications for scanning. In addition, the improved quality of CT has resulted in an increased detection of incidental findings. While some have clinical significance, many are trivial with appreciable investigatory cost implications.

Materials and Methods
We performed a retrospective review of all emergency abdominal CT scans performed at a tertiary referral university-affiliated hospital from 1st January 2012 to 31st December 2012. Our objective was to evaluate the prevalence of incidental findings detected on CT scans, and the need for further diagnostics to the complete work-up.

Result
During the study period, there were 1,274 abdominal CT scans performed in an emergency setting. Main indications for scanning included; 85.9% (n=1,095) had abdominal pain, 22.3% (n=284) had vomiting 16% (n=204) had altered bowel habit, while 11.3% (n=144) had a history of trauma. 20.1% (n=256) had incidental findings detected. (See Table 1. For breakdown of incidental findings). Recommended follow-up diagnostics by radiology department included; 120 targeted CT scans, 32 colonoscopies, 32 targeted magnetic resonance imaging (MRI), 8 targeted ultrasounds, 5 gastroscopies and 4 cystoscopies. See table 1.

Conclusion
CT use in the emergency setting has increased significantly in recent years. Though some studies have observed a decline in admission rates with its use, there has been a significant increase in incidental pathology detection. Though many of these findings are benign and warrant no intervention, others require significant surveillance and/or treatment.