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Errors in the Interpretation of the Non-traumatic Acute Abdomen

  • Antonella Filippone
  • Roberta Cianci
  • Antonio R. Cotroneo

Abstract

The term “acute abdomen” defines a clinical syndrome characterized by the sudden onset of severe abdominal pain requiring emergency medical or surgical treatment [1]. In a review of approximately 30,000 patients with acute abdomen, de Bombal [2] observed that the most common causes of acute abdominal pain were represented by appendicitis, acute cholecystitis, and small-bowel obstruction whereas in one third of patients no cause could be determined. Since many of these conditions may have similar early clinical presentations, diagnostic imaging tools including abdominal plain film (APF), ultrasound (US), and multidetector computed tomography (MDCT) play a pivotal role in the management of patients presenting to the emergency department with acute non-traumatic abdominal pain.

Keywords

Small Bowel Obstruction Acute Cholecystitis Acute Abdominal Pain Acute Diverticulitis Abdominal Plain Film 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Silen W (1996) Cope’s early diagnosis of the acute abdomen, 19th ed. Oxford University Press, New YorkGoogle Scholar
  2. 2.
    de Bombal FT (1991) Introduction. In: de Bombal FT (ed) Diagnosis of acute abdominal pain, 2nd ed. Churchill Livingstone, Edinburgh, pp 1–10Google Scholar
  3. 3.
    Mindelzun RE, Jeffrey RB Jr (1997) Unenhanced helical CT for evaluating acute abdominal pain: a little more cost, a lot more information. Radiology 205:43–47PubMedGoogle Scholar
  4. 4.
    Malone AJ Jr, Wolf CR, Malmed AS, Melliere BF (1993) Diagnosis of acute appendicitis: value of unenhanced CT. Am J Roentgenol 160:763–766Google Scholar
  5. 5.
    Lane MJ, Katz DS, Ross BA et al (1997) Unenhanced helical CT for suspected acute appendicitis. Am J Roentgenol 168:405–409Google Scholar
  6. 6.
    Rao PM, Rhea JT, Novelline RA et al (1997) Helical CT technique for the diagnosis of appendicitis: prospective evaluation of a focused appendix CT examination. Radiology 202:139–144PubMedGoogle Scholar
  7. 7.
    Puylaert JB, Rutgers PH, Lalisang RI et al (1987) A prospective study of ultrasonography in the diagnosis of appendicitis. N Engl J Med 317:666–669PubMedCrossRefGoogle Scholar
  8. 8.
    Lane MJ, Liu DM, Huynh MD et al (1999) Suspected acute appendicitis: non-enhanced helical CT in 300 consecutive patients. Radiology 213:341–346PubMedGoogle Scholar
  9. 9.
    Miki T, Ogata S, Uto M et al (2005) Enhanced multidetector-row computed tomography (MDCT) in the diagnosis of acute appendicitis and its severity. Radiat Med 23:242–255PubMedGoogle Scholar
  10. 10.
    Kamel IR, Goldberg SN, Keogan MT et al (2000) Right lower quadrant pain and suspected appendicitis: non focused appendiceal CT-review of 100 cases. Radiology 217:159–163PubMedGoogle Scholar
  11. 11.
    Paulson EK, Harris JP, Jaffe TA et al (2005) Acute appendicitis: added diagnostic value of coronal reformations from isotropic voxels at multidetector row CT. Radiology 235:879–885PubMedCrossRefGoogle Scholar
  12. 12.
    Zangos S, Steenburg SD, Phillips KD et al (2007) Added diagnostic value of coronal reformations with 64-slice multidetector row computed tomography. Acta Radiol 14:19–27Google Scholar
  13. 13.
    Aufort S, Charra L, Lesnik A et al (2005) Multidetector CT of bowel obstruction: value of post-processing. Eur Radiol 15:2323–2329PubMedCrossRefGoogle Scholar
  14. 14.
    Pereira JM, Sirlin CB, Pinto PS et al (2004) Disproportionate fat stranding: a helpful CT sign in patients with acute abdominal pain. RadioGraphics 24:703–715PubMedCrossRefGoogle Scholar
  15. 15.
    Shin LK, Halpern D, Weston SR et al (2005) Prospective CT diagnosis of stump appendicitis. Am J Roentgenol 184:62–64Google Scholar
  16. 16.
    Levine CD, Aizenstein O, Lehavi O, Blachar A (2005) Why we miss the diagnosis of appendicitis on abdominal CT: evaluation of imaging features of appendicitis incorrectly diagnosed on CT. Am J Roentgenol 184:855–859Google Scholar
  17. 17.
    Grassi R, Di Mizio R, Pinto A et al (2004) Serial plain abdominal film findings in the assessment of acute abdomen: spastic ileus, hypotonic ileus, mechanical ileus and paralytic ileus. Radiol Med 108:56–70PubMedGoogle Scholar
  18. 18.
    Felzko PJ, Mezwa DG, Farah MC, White BD (1992) Clinical significance of pneumatosis of the bowel wall. RadioGraphics 12:1068–1078Google Scholar
  19. 19.
    Ahneida AT, Melão L, Viamonte B et al (2009) Epiploic appendagitis: an entity frequentely unknown to clinicians-diagnostc imaging, pitfalls, and look-alikes. Am J Roentgenol 193:1243–1251CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Antonella Filippone
    • 1
  • Roberta Cianci
    • 1
  • Antonio R. Cotroneo
    • 1
  1. 1.Department of Neurosciences and Imaging, Section of Radiological Imaging“G. d’Annunzio” UniversityChietiItaly

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