Goals: To determine the utility of plain abdominal radiography in the initial evaluation of acute gastrointestinal (GI) hemorrhage in a medical intensive care unit. Background: Plain abdominal radiographs are frequently used in the routin e evaluation of patients with GI bleeding. The utility of these studies in the i ntensive care unit setting is unclear. Study: The study was a retrospective char t review of 71 adult subjects admitted to a medical intensive care unit with the diagnosis of GI bleeding.Subjects were excluded if they presented with peritone al signs,received an abdominal CT scan in the 24 hours prior to admission,or wer e chronically treated with immunosuppressive medication. Subjects were divided i nto two cohorts based on whether or not they underwent plain abdominal radiograp hy during the first hospital day. The primary study endpoints were hospital mort ality, intensive care unit length of stay, and whether or not radiographic findi ngs altered clinical management.Results: Of the 71 patients admitted with a diag nosis of GI bleeding (mean age 65.8 ±14.5 years, 73.2%male), 56(79%) had a plain abdominal radiograph performed. Subjects who had a plain film did not differ significantly from those who did not in age, ge nder, degree of anemia, degree of coagulopathy,or in severity of illness as meas ured by Acute Physiology and Chronic Health Evaluation (APACHE II) score. There was no statistically significant difference in hospital mortality or intensive c are unit length of stay between patients who received plain films and those who did not. In no subject (0%; 95%confidence interval, 0%-5.4%) did abdominal radiography reveal an abnormality that altered clinical management. Conclusions: Based on our observations, plain films of the abdomen do not appear to alter cli nical outcomes or management decisions for patients with GI bleeding and normal abdominal examinations who are admitted to the intensive care unit. Goals: To determine the utility of plain abdominal radiography in the initial evaluation of acute gastrointestinal (GI) hemorrhage in a medical intensive care unit. Background: Plain abdominal radiographs are frequently used in the routin e evaluation of patients with GI bleeding. The utility of study: the study was a retrospective char t review of 71 adult subjects admitted to a medical intensive care unit with the diagnosis of GI bleeding. Subjects were excluded if they presented with peritone al signs , received an abdominal CT scan in the 24 hours prior to admission, or wer e chronically treated with immunosuppressive medication. Subjects were divided i nto two cohorts based on whether or not they underwent plain abdominal radiograp hy during the first hospital day. The primary study endpoints were hospital mort ality, intensive care unit length of stay, and whether or not radiographic findi ngs altered clinical management.R Of the 71 patients admitted with a diag nosis of GI bleeding (mean age 65.8 ± 14.5 years, 73.2% male), 56 (79%) had a plain abdominal radiograph performed. Subjects who had a plain film did not differ significantly from those who did not in age, ge nder, degree of anemia, degree of coagulopathy, or in severity of illness as meas ured by Acute Physiology and Chronic Health Evaluation (APACHE II) score. There was no statistically significant difference in hospital mortality or intensive In no subject (0%; 95% confidence interval, 0% -5.4%) did abdominal radiography reveal an abnormality that altered clinical management. Conclusions: Based on our observations, plain films of the abdomen do not appear to alter cli nical outcomes or management decisions for patients with GI bleeding and normal baby examinations who are admitted to the intensive care unit.