Abstract
Abdominal pain is a common presenting complaint in the emergency department (ED). A thorough history, physical examination, and knowledge of current guidelines can help the clinician select the most accurate, appropriate diagnostic imaging. Separating the abdomen into quadrants is useful in understanding the common etiologies that lead to abdominal pain. Right upper quadrant (RUQ) pain generally derives from a hepatobiliary source, while epigastric and left upper quadrant (LUQ) most commonly are gastric, pancreatic, or associated with other etiologies. Lower abdominal pain, both on the right and left side, is associated most commonly with intestinal or genitourinary problems. By understanding the locations of abdominal pain in relation to differential diagnosis, the most accurate and clinically validated imaging modalities can be obtained.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Mattson B, Dulaimy K. The 4 quadrants: acute pathology in the abdomen and current imaging guidelines. Semin Ultrasound CT MR. 2017;38(4):414–23.
Hastings RS, Powers RD. Abdominal pain in the ED: a 35-year retrospective. Am J Emerg Med. 2011;29(7):711–6.
McNamara R, Dean AJ. Approach to acute abdominal pain. Emerg Med Clin North Am. 2011;29(2):159–73.
Natesan S, Lee J, Volkamer H, Thoureen T. Evidence-based medicine approach to abdominal pain. Emerg Med Clin North Am. 2016;34(2):165–90.
Nagurney JT, Brown DF, Chang Y, Sane S, Wang AC, Weiner JB. Use of diagnostic testing in the emergency department for patients presenting with non-traumatic abdominal pain. J Emerg Med. 2003;25(4):363–71.
Gans SL, Pols MA, Stoker J, Boermeester MA. Experts steering group. Guideline for the diagnostic pathway in patients with acute abdominal pain. Dig Surg. 2015;32(1):23–31.
Lameris W, van Randen A, van Es HW, van Heesewijk JP, van Ramshorst B, Bouma WH, et al. Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study. BMJ. 2009;338:b2431.
Millet I, Sebbane M, Molinari N, Pages-Bouic E, Curros-Doyon F, Riou B, et al. Systematic unenhanced CT for acute abdominal symptoms in the elderly patients improves both emergency department diagnosis and prompt clinical management. Eur Radiol. 2017;27(2):868–77.
Bektas F, Eken C, Soyuncu S, Kusoglu L, Cete Y. Contribution of goal-directed ultrasonography to clinical decision-making for emergency physicians. Emerg Med J. 2009;26(3):169–72.
Stoker J, van Randen A, Lameris W, Boermeester MA. Imaging patients with acute abdominal pain. Radiology. 2009;253(1):31–46.
Summers SM, Scruggs W, Menchine MD, Lahham S, Anderson C, Amr O, et al. A prospective evaluation of emergency department bedside ultrasonography for the detection of acute cholecystitis. Ann Emerg Med. 2010;56(2):114–22.
Kendall JL, Shimp RJ. Performance and interpretation of focused right upper quadrant ultrasound by emergency physicians. J Emerg Med. 2001;21(7):7–13.
Taylor MR, Lalani N. Adult small bowel obstruction. Acad Emerg Med. 2013;20(6):528–44.
Smith JE, Hall EJ. The use of plain abdominal x-rays in the emergency department. Emerg Med J. 2009;26(3):160–3.
Rubano E, Mehta N, Caputo W, Paladino L, Sinert R. Systematic review: emergency department bedside ultrasonography for diagnosing a suspected abdominal aortic aneurysm. Acad Emerg Med. 2013;20(2):128–38.
Rao PM, Rhea JT, Novelline RA, Mostafavi AA, McCabe CJ. Effect of computed tomography of the appendix on treatment of patients and use of hospital resources. N Engl J Med. 1998;338(3):141–6.
Tremblay E, Therasse E, Thomassin-Naggara I, Trop I. Quality initiatives: guidelines for use of medical imaging during pregnancy and lactation. Radiographics. 2012;32(3):897–911.
Graif M, Itzchak Y. Sonographic evaluation of ovarian torsion in childhood and adolescence. AJR Am J Roentgenol. 1988;150(3):647–9.
Destigter KK, Keating DP. Imaging update: acute colonic diverticulitis. Clin Colon Rectal Surg. 2009;22(3):147–55.
Anderson SW, Soto JA. Multi-detector row CT of acute non-traumatic abdominal pain: contrast and protocol considerations. Radiol Clin N Am. 2012;50(1):137–47.
Rekant EM, Gibert CL, Counselman FL. Emergency department time for evaluation of patient discharged with a diagnosis of renal colic: unenhanced helical computed tomography versus intravenous urography. J Emerg Med. 2001;21(4):371–4.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Folkerson, L.E., Kosoko, A.A. (2019). What Imaging Strategies Are Effective for Rapid and Accurate Diagnosis of Abdominal Pain Etiologies?. In: Graham, A., Carlberg, D.J. (eds) Gastrointestinal Emergencies. Springer, Cham. https://doi.org/10.1007/978-3-319-98343-1_4
Download citation
DOI: https://doi.org/10.1007/978-3-319-98343-1_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-98342-4
Online ISBN: 978-3-319-98343-1
eBook Packages: MedicineMedicine (R0)