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The authors note no overall sensitivity difference across causes, but better diagnostic relevance of erect radiographs in bowel obstruction. The letter raises questions about CT diagnoses, decision-making impact on therapy, and limitations of erect positioning due to pain, while emphasizing the continued role of conventional radiographs and practical imaging considerations in emergency care.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/supine-and-erect-abdominal-radiographs-are-both-feasible-in-patients-with-acute-abdomen-letter-to-the-editor/436951/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/supine-and-erect-abdominal-radiographs-are-both-feasible-in-patients-with-acute-abdomen-letter-to-the-editor/436951.png","ImageObject",300,407,{"name":92,"@type":93},"Đào","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What main point does the letter make about supine versus erect abdominal radiographs in acute abdomen?","Question",{"text":112,"@type":113},"It acknowledges the referenced study’s findings, including the lack of significant sensitivity differences overall and better diagnostic relevance of erect radiographs for bowel obstruction, while questioning how much radiograph positioning should change management.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What questions does the letter raise about the CT-based diagnostic assessment?",{"text":117,"@type":113},"It asks whether a single CT scan could yield more than one diagnosis for the same patient and requests clarification on the rationale and evaluation strategy for acute abdomen.",{"name":119,"@type":110,"acceptedAnswer":120},"Why does the letter discuss limitations of using erect radiographs in patients?",{"text":121,"@type":113},"It notes that patients with acute abdomen may find standing uncomfortable and that pain can lead to poor or distorted standing posture during examination.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},436951,1791278807,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24,"preview_page_count":4},1374402968488,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","J Chin MedAssoc  \nLetter to the editor  \nSupine and erect abdominal radiographs are both feasible in patients with acute abdomen  \nSzu-Ting Yanga,b, Hung-Hsien Liuc, Peng-Hui Wanga,b,d,e,*  \naDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cDepartment of Medical Imaging and Intervention, Tucheng Hospital, New Taipei City, Taiwan, ROC; dFemale Cancer Foundation, Taipei, Taiwan, ROC; eDepartment of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC  \nDEAR EDITOR,  \nWe have read the article entitled “Diagnostic values of supine and erect abdominal radiographs for patients with acute abdomen: which is better for decision making?”published in the June issue of the Journal of the Chinese Medical Association with interest.1 Lee et al.1 tried to evaluate whether supine or erect abdominal radiographs are more suitable in cases of acute abdomen. The authors found that there was no significant difference in diagnostic sensitivity between the two modalities among all causes-inducing acute abdomen. As for bowel obstruction, the study revealed statistically better diagnostic relevance in erect abdominal radiographs. We congratulated the authors’successful publication but there are some questions that need clarification.  \nFirst, is it possible that one computed tomography (CT) scan reported more than one diagnosis? For example, a patient might simultaneously have a tubo-ovarian abscess associated with either adynamic ileus or obstructive bowel syndrome. Could the authors kindly provide the rationale about their strategy to evaluate the acute abdomen or whether their study would influence the further therapeutic plan (surgical intervention or conservative treatment)? Second, the authors concluded that erect abdominal radiographs were strongly suggested to use if highly suspected bowel obstruction. We appreciated the authors’effort to propose this recommendation; however, no matter whether an erect or supine abdominal radiograph was used, it may hardly influence the decision and the subsequent management as shown above. In cases with extremely severe abdominal pain or uncertain diagnosis of acute abdomen, most of the clinicians may arrange a CT scan for further evaluation regardless of abdominal radiograph findings.2–5 Besides, it is uncomfortable and difficult for patients with acute abdomen to keep an erect  \n* Address correspondence. Dr. Peng-Hui Wang, Department of Obstetricsand Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail address: phwang@vghtpe.gov.tw](ROC. E-mail address: phwang@vghtpe.gov.tw);  \n[pongpongwang@gmail.com](pongpongwang@gmail.com) (P.-H. Wang).  \nConflicts of interest: Dr. Peng-Hui Wang, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2023) 86: 131-132.  \nReceived August 3, 2022; accepted. August 6, 2022.  \ndoi: 10. 1097/JCMA.0000000000000795.  \nCopyright © 2022, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \nposture. Additionally, the position of standing may be much detorted during the examination because of intolerance of pain.  \nDespite the aforementioned questions, the authors provided evidence of abdominal radiographs choice regarding to acute abdomen.1 Based on this study, clinicians may save their time and effort to struggle with whether erect or supine abdominal radiographs should be taken. Though the CT scan had ","cbCaidXAaP1YfR3o","https://ap.wps.com/l/cbCaidXAaP1YfR3o","pdf",286654,"English","# Letter to the editor\n## Questions on CT diagnosis and evaluation strategy\n## Impact of radiograph position on clinical management\n## Role of conventional imaging and emergency considerations\n## Acknowledgments\n## References","[{\"question\":\"What main point does the letter make about supine versus erect abdominal radiographs in acute abdomen?\",\"answer\":\"It acknowledges the referenced study’s findings, including the lack of significant sensitivity differences overall and better diagnostic relevance of erect radiographs for bowel obstruction, while questioning how much radiograph positioning should change management.\"},{\"question\":\"What questions does the letter raise about the CT-based diagnostic assessment?\",\"answer\":\"It asks whether a single CT scan could yield more than one diagnosis for the same patient and requests clarification on the rationale and evaluation strategy for acute abdomen.\"},{\"question\":\"Why does the letter discuss limitations of using erect radiographs in patients?\",\"answer\":\"It notes that patients with acute abdomen may find standing uncomfortable and that pain can lead to poor or distorted standing posture during examination.\"}]","Supine and erect abdominal radiographs are both feasible in patients with acute abdomen - Letter to the editor | PDF",1790679574]