CT Abdomen and Pelvis
CTNICE NG1472019NICE NG1042018, updated 2020NICE NG1562020NICE NG1182019NICE NG392016NICE NG1512020RCS Emergency General Surgeryv2.0 · March 2026
Varies
EDInpatientOutpatient
All imaging requests must be justified by an IR(ME)R practitioner (radiologist or radiographer)Acute surgical — ED
— ANY of the following
- Suspected appendicitis — USS first in women of childbearing age
- Suspected perforated viscus
- Suspected acute mesenteric ischaemia — BIPHASIC CTA (arterial + portal venous)
- Suspected bowel obstruction
- Suspected ischaemic colitis
- Acute diverticulitis with raised inflammatory markers — within 24 hoursNICE NG147 Rec 1.3.5
- Suspected intra-abdominal/pelvic collection/abscess
- Suspected liver abscess
- Suspected retroperitoneal haemorrhage
Sepsis/infection
— ANY of the following
- Abdominal sepsis of unknown source
- Suspected complicated pyelonephritis
Post-operative
— ANY of the following
- Anastomotic leak, internal hernia, bowel obstruction post-surgery
- Small bowel leak or enterocutaneous fistula
Oncological — outpatient
— ANY of the following
- Colorectal cancer staging: CT chest/abdomen/pelvisNICE NG151
- Acute complications of malignancy
CT KUB
Low-dose non-contrast — specify on request card
- Suspected renal/ureteric calculus within 24 hoursNICE NG118 Rec 1.1.1
- Do NOT use standard contrast-enhanced CT for renal colic
- IVU is SUPERSEDED
- USS first-line for pregnant womenNICE NG118 Rec 1.1.2
Notes
Information
CT KUB is low-dose non-contrast — specify on request card
Warning
USS first for appendicitis in women of childbearing age
Removed
Non-acute suspected cancer removed — use 2WW pathway (NG12)
NICE NG12Information
For AAA, use CT Aorta protocol
Information
IVU superseded — no longer recommended
Radiation Dose
CT abdomen/pelvis ~8–14 mSv. CT KUB (low-dose) ~3–5 mSv.
Pregnancy
CT abdomen/pelvis should not be withheld if clinically indicated in pregnancy. USS is first-line for renal colic and appendicitis in pregnancy.
Change Log
v1.02026-03-05Initial publication
v2.02026-03-08Expanded to include sepsis, post-op, oncological staging. IVU superseded note. Pregnancy guidance added.