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Imaging patients with acute abdomen
Which imaging techniques should be used when
- By: Lee Grant, F A Hampson, A S Shaw
The acute abdomen is a clinical condition characterised by the sudden onset of severe abdominal pain that requires medical or surgical management. Early and accurate diagnosis can minimise morbidity and mortality. Physical examination and laboratory investigations are often non-specific, and imaging plays an increasingly important part in diagnosis. With interpretation appreciably influenced by clinical history it is vital that all relevant clinical details are communicated to the radiologist.
Different imaging techniques have their strengths and weaknesses, and an understanding of these will help in planning a rational imaging strategy. We also give several common scenarios based on patients who presented with an acute abdomen and discuss the most appropriate imaging techniques.
Abdominal radiography—Plain radiography has a low diagnostic yield and is often misinterpreted. However, it is important to look for areas of abnormal calcification, free air, or abnormally dilated bowel loops (small bowel loops should measure less than 3 cm