Acute abdominal pain: Diagnostic strategies

Abstract

5.1.4 Conclusion: The optimal imaging strategy in patients presenting with acute abdominal pain highly depends on the topographical localization of pain, the ability of clinical examination to shorten the list of probable diagnoses in the individual patient, the radiological equipment readily available in the emergency situation, and the experience of the radiologist investigating the imaging studies. In the past few years, CT has gained widespread acceptance as the first-line imaging modality in the diagnostic work-up of most patients presenting with acute abdominal pain, because it is the most time-effective and accurate imaging technique, and, if the working clinical diagnosis is incorrect, CT provides sufficient information for an alternative diagnosis. However, in general, for optimal diagnostic accuracy the CT imaging technique has to be tailored to specific questions; therefore, the initial history and physical examination have to focus the abdominal pain to a particular anatomic region or specific diagnosis and close cooperation between referring physician and radiologist is a prerequisite for rapid and accurate diagnosis. © 2007 Springer-Verlag Berlin Heidelberg.