TY - CHAP M1 - Book, Section TI - Chapter 1. Acute Abdominal Pain: Basic Principles & Current Challenges A1 - Makrauer, Frederick L. A1 - Greenberger, Norton J. A2 - Greenberger, Norton J. A2 - Blumberg, Richard S. A2 - Burakoff, Robert PY - 2012 T2 - CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 2e AB - Nonsurgical causes of acute abdominal pain simulating an acute abdomen account for up to 30% of patients requiring hospital admission.Multidetector-row computed tomography (MDCT) is the benchmark imaging modality in the evaluation of acute abdominal pain except in patients with right upper quadrant (RUQ) pain and abnormal liver function tests (LFTs) or in women who are, or may be, pregnant.Ultrasound is the initial imaging study of choice in patients with RUQ pain, abnormal LFTs, and suspicion of biliary tract disease.Ultrasound is the preferred initial imaging study for young women and those who are pregnant.Always perform imaging studies preoperatively in patients with a clinical diagnosis of acute appendicitis.Irritable bowel syndrome, functional abdominal pain syndrome, and anxiety disorder may confound accurate diagnosis and are associated with an increased rate of negative appendectomy.Narcotic pain medication, if indicated, should not be withheld from a patient with abdominal pain; it will not reduce the recognition of key physical findings and may improve diagnostic accuracy by relaxing the patient.The patient's cumulative radiation dose must always be considered before choosing an imaging study, particularly in the young and women of childbearing age.Prior abuse should always be considered in patients with recurrent unexplained abdominal pain, regardless of the patient's age or gender. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/10/15 UR - accessmedicine.mhmedical.com/content.aspx?aid=55955001 ER -