RT Book, Section
A1 Makrauer, Frederick L.
A1 Greenberger, Norton J.
A2 Greenberger, Norton J.
A2 Blumberg, Richard S.
A2 Burakoff, Robert
SR Print(0)
ID 55955001
T1 Chapter 1. Acute Abdominal Pain: Basic Principles & Current Challenges
T2 CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 2e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-176848-1
LK accessmedicine.mhmedical.com/content.aspx?aid=55955001
RD 2024/04/24
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.