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Radiology in the Pregnant Patient with Acute Abdominal Pain

  • Mustafa M. AlikhanEmail author
Chapter

Abstract

Abdominal and pelvic pain in the pregnant patient is a very common problem that can cause diagnostic dilemmas for the surgeon due to the normal physiologic changes of pregnancy. Imaging of the acute abdomen has progressively increased in pregnancy secondary to its importance in yielding a cohesive diagnosis. However, there are practical considerations that the surgeon must be aware of in order to mitigate risks to the developing fetus and mother. Many of the basic imaging modalities in the field of radiology utilize ionizing radiation which is known to be harmful to a developing fetus. The American College of Radiology (ACR) thus recommends utilizing imaging techniques that are free of radiation. Those studies that utilize radiation should be reserved for emergent cases only when other options are nondiagnostic or not possible. The surgeon should be cognizant of the ramifications of radiation during pregnancy. Ultrasonography is the first-line imaging modality due to its wide availability, lack of radiation, and ease of use. MRI is considered a second-line modality because it is less readily available but may be requisite since ultrasound may not be able to see deep within the abdomen and pelvis. Additionally, MRI offers superior contrast resolution of soft tissues and can show fluid collections more distinctly. A practical understanding of the way to employ these imaging modalities on different pathologic states is incumbent for the pregnant patient.

Keywords

Acute abdomen Epigastric pain Abdominal pain Pregnancy MRI pregnancy Ultrasound appendicitis Fetal radiation Fetal exposure Non-obstetric abdominal pain MRI acute appendicitis CT pregnant Pregnant surgery Appendicitis Nephrolithiasis 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of RadiologyTripler Army Medical CenterHonoluluUSA

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