The term acute abdomen defines a clinical syndrome characterized by the sudden onset of severe abdominal pain, requiring early medical or surgical treatment. The authors center their discussion on new advances in the imaging of the acute abdomen using mr and dual source ct technology. Acute abdomen vanderbilt university medical center. For the gastrointestinal tract, some of the main indications for mdct are to evaluate for obstruction or inflammation of the small bowel and colon. The remaining chapters describe specific applications of mdct, dect, and mri for the imaging of both common and less common acute abdominal and pelvic conditions, including disorders. Gangrene and perforation of the gut can occur abdomen and pelvis. Multidetector computed tomography hatem alkadhi of acute. Nevertheless, only one quarter of patients who have previously been classified with an acute. Jul 15, 20 acute abdomen is a medical emergency, in which there is sudden and severe pain in abdomen of recent onset with accompanying signs and symptoms that focus on an abdominal involvement. Acute abdominal pain is a frequent complaint in the emergency department. Ultrasound is readily available, transportable, and has no ionizing radiation but it is relatively insensitive with obesity, intrinsic bowel or retroperitoneal disease, and. It can represent a wide spectrum of conditions, ranging from a benign and selflimiting disease to a surgical emergency. Although it is oftentimes held for a purely surgical problem, two thirds of patients do not require operative management.
Multidetector computed tomography hatem alkadhi of acute abdomen. It is beneficial to localize the perforation site as well as to diagnose the presence of bowel perfora. Contrastenhanced multidetector computed tomography cemdct is the current modality of choice for evaluating acute abdominal pain in. Katz, mariano scaglione this superbly illustrated book describes a comprehensive and modern approach to the imaging of abdominal and pelvic emergencies of traumatic and nontraumatic origin. An 84yearoldwoman presented with fever and abdominal pain in the right lower quadrant. Mdct findings according to the perforation sites our objective is to describe the characteristic ct findings of gastrointestinal gi tract perforations at various levels of the gastrointestinal system. Recent important developments in ct, including multislice ct and multiplanar reconstructions, receive particular attention. Ecr 2011 c2344 the role of mdct in the evaluation of. Mdct evaluation of acute aortic syndrome aas the british. The acute abdominal pain may be due to trauma or nontrauma diseases and it is a frequent condition in patients presenting to the hospital emergency department. Ct is found out to be more informative and accurate, its findings have been known to have drastic effect in managing the patients with acute pain in abdomen. Mdct has improved abdominal imaging by providing the ability to obtain thinner slices to improve spatial resolution and shorter acquisiton times. Role of mdct 128 slice scanner in acute abdomen eprints. The book is organized using an organ system approach.
The pain is of acute onset, often very severe, and nontraumatic. Also called surgical abdomen in contrast to peritonitis inflammation of the peritoneum. Currently, mdct is an indispensable examination in the initial evaluation of patients presenting with an acute abdomen. Practice guidelines for primary care of acute abdomen 2015. Mdct and mr imaging of acute abdomen new technologies and. The initial assessment should attempt to determine if the patient has an acute surgical problem that requires immediate and prompt surgical intervention, or urgent medical therapy. This includes individuals with acute colitis, where the initial diagnosis is clinically suspected in less than half of cases, as the presentation may be rather vague with atypical andor febrile acute abdomen. Definitions acute abdomen intraabdominal process causing severe, usually sudden onset pain and often requiring surgical intervention.
Computerized tomography ct is a scanner diagnostic that allows you to create a series of scans of bones, blood vessels, and soft tissue from different angles or cross sections using x rays. To evaluate the accuracy and impact of early ct in the diagnosis of non traumatic acute abdomen when usg or xray findings are negative, equivocal or unable to provide additional information regarding the diagnosis. In the second session the two examiners were asked to make a definite diagnosis in obstructive cases, finally verified by the. Multidetector computed tomography mdct of the abdomen is the technique of choice for evaluating patients with acute pain. In fact, mdct allows for correct diagnosis, contributes to appropriate treatment planning and provides important prognostic information thanks to its ability to define the. Canine patients with acute abdominal signs are often clinically unstable and need a rapid and accurate diagnosis. E7890 december 2005 with 2,341 reads how we measure reads. Non enhanced msct in diagnosis of causes of acute abdomen. Mdct and mr imaging of acute abdomen michael patlas, douglas s. The first two chapters explain an evidencebased approach to the evaluation of patients and present dose reduction strategies for multidetector ct imaging mdct. The term acute abdominal pain can be applied if the pain has less than 72 hours of evolution. Mdct is an excellent examination technique forevaluationpatients with acute abdomen, particularly useful in defining the cause and therapeutic strategy in thesepatients. Acute abdomen symptoms and differential diagnoses medical. Contrastenhanced ct of the abdomen was performed for further evaluation.
The fate of peripancreatic fluid collections was investigated, and the incidence and type of local complications were recorded and correlated to the ct grading system ae. Mar 18, 2020 the phrase acute abdomen should, therefore, be carefully selected in a clinical context. The remaining chapters describe specific applications of mdct, dect, and mri for the imaging of both common and less common acute abdominal and pelvic conditions, including disorders in the pediatric population and pregnant patients. To assess the efficacy of mdct in differentiating the various pathological causes of acute abdomen. The acute abdomen requires rapid and specific diagnosis as several etiologies demand urgent operative intervention. Contrastenhanced ct of the abdomen was performed for further. Multidetectorrow computed tomography mdct is the benchmark imaging modality in the evaluation of acute abdominal pain except in women fewer than 25 weeks pregnant. The purpose of this study was to evaluate the role of mdct in diagnosing acute abdominal pain in children visiting the ed. One hundred and eighteen patients with suspected appendicitis underwent abdominal mdct. It may be the sole indicator of the need for surgery and must be attended to swiftly. This superbly illustrated book describes a comprehensive and modern approach to the imaging of abdominal and pelvic emergencies of traumatic and nontraumatic origin. Acute abdomen is any acute abdominal condition requiring a quick response.
Practice guidelines for primary care of acute abdomen 2015 that were the. The role of mdct in the evaluation of patients with acute abdomen. Ct is a fast, painless, noninvasive and precise method. The role of mdct in the evaluation of patients with acute.
Mdct has earned this role because it can provide a global perspective of the gut, mesenteries, omenta, peritoneum, retroperitoneum, subperitoneum, and extraperitoneum uninhibited by the presence of bowel gas and fat. Acute and severe abdominal pain, however, is almost always a symptom of intraabdominal disease. Abdominal pain is the most important and the most frequent complaint in patients presenting with an acute abdomen in emergency settings. Epidemiology of acute abdominal pain in adults in the emergency department setting 2. For the gastrointestinal tract, some of the main indications for mdct are to evaluate for obstruction or.
Multidetector computed tomography mdct, however, has become the premier technique for triage of most patients with acute abdomen. Endoscopic, laparoscopic and laparoscopicassisted procedures are now being increasingly performed instead of conventional laparotomy 2, 3. Pdf role of mdct 128 slice scanner in acute abdomen. Multidetector computed tomography mdct is a powerful modality for pinpointing the most likely site and cause of acute abdominal pain in the immunocompromised host. To explore the sensitivity and specificity of mdct in acute abdomen cases with intraoperative surgical finding histopathological findings clinical. Multidetector computed tomography of the acute abdomen in the. Background the term acute abdomen refers to a clinical syndrome characterized by a sudden, severe abdominal pain, requiring in many cases surgical treatment. Multidetector computed tomography mdct is a fundamental imaging technique that must be promptly performed in all patients with acute abdomen and suspected bowel ischemia. To evaluate the accuracy of mdct 128 slices in the diagnosis of acute abdomen 2. This article discusses the causes of the acute abdomen in the immunocompromised host, illustrates the typical findings on mdct, and discusses potential limitations of mdct in. Mdct evaluation of nontraumatic acute abdomen eprints.
Contrastenhanced ct of the abdomen and pelvis was performed to further evaluate the abdomen. Download pdf ct of the acute abdomen free online new. Acute abdominal pain is one of the most commonly encountered leading symptoms in the emergency department. With the recently developed 16mdct scanner, it is now possible to scan the entire abdomen and pelvis within a breathhold at a resolution of less than 1 mm 0. The fate of peripancreatic fluid collections was investigated, and the incidence and type of local complications were. May 28, 2014 multidetector computed tomography mdct is a fundamental imaging technique that must be promptly performed in all patients with acute abdomen and suspected bowel ischemia. Mdct and mr imaging of acute abdomen new technologies. Ct features are clearly illustrated, and pitfalls and differential diagnoses are discussed. Download ct of the acute abdomen ebook pdf or read online books in pdf, epub, and mobi format. Because there is frequently a progressive underlying intraabdominal disorder, undue delay in diagnosis and treatment may adversely affect outcome.
Mdct and mr imaging of acute abdomen michael patlas. Contrastenhanced multidetector computed tomography ce mdct is the current modality of choice for evaluating acute abdominal pain in people. Plain abdominal radiographs and ultrasound of the abdomen were normal. A subset of patients may present with delayed symptoms, abscess mimicking an abdominal mass, or with sepsis. Mdct clues for identification of aetiology styliani pouli1, androniki kozana1. Multidetector computed tomography in the evaluation of. Assessment of acute abdomen in the emergency department.
The acute abdomen is defined as a sudden onset of severe abdominal pain of less than 24 hours duration. The mainstay of treatment for bowel perforation is surgery. Because the new multidetector ct mdct scanner generations provide increased speed, greater volume coverage and thinner slices, the acceptance of ct for abdominal imaging has increased rapidly. It has a large number of possible causes and so a structured approach is required. Ultrasonogram was done as the initial modality in these patients and ct. Evaluation of acute abdominal pain in adults sarah l. Acute abdominal pain in obese and overweight patients. Assessment of acute abdomen in the emergency department mario luka csenar summary. Imaging plays an important role for an accurate diagnosis, which in turn diminishes morbidity and mortality jastaniah and salih demonstrate optimum ct aspects and emphasize on the important features of ct for those patients presenting with an acute abdominal pain at the. These data sets result in voxels that are both submillimeter in dimension and isotropic, suggesting that reformations in any desired plane will have. Abdominal examination revealed generalized tenderness and distension. Role of ultrasound and mdct in evaluation of patients with.
Mdct in the evaluation of patients with acute abdomen and to describe the optimal ct technique and ct findings of the most common disorders that can cause acute abdominal pain. Ample information including a randomized trial shows that the best diagnostic imaging test in these clinical scenarios is multidetector ct mdct. The goal of this article is to discuss the role of mdct in the diagnostic workup of acute abdominal pain. A total of 156 patients with acute abdominal pain 85 males and 71 females, age 117 years. Ct of the acute abdomen provides a comprehensive account of the use of ct in patients with acute abdomen. The differential diagnosis for acute abdominal pain includes a broad spectrum of clinical entities ranging from selflimited entities to severe diseases with high mortality rates. In 156 children with acute abdominal pain who underwent mdct in the ed, the three most frequent diagnoses were appendicitis 41%, inflammatory bowel disease 36%, and ovarian cyst 5%. A 66yearold man presented with a 5day history of abdominal pain. The role of us examination in the management of acute abdomen. Mdct of abdomen gastroenterology what is ct of abdomen and small pelvis. The acute abdomen is one of the most frequent causes for presentation to the emergency department.
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