Abdominal and pelvic pain

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Author: Mikael Häggström [notes 1]

Unspecific location

In acute abdominal pain with otherwise no specific indication of its origin, a CT of the abdomen and pelvis is generally indicated.

Right upper quadrant pain

Abdominal ultrasonography is generally the investigation of choice, at least in younger people.

Cholecystitis

Cholecystitis is indicated by upper right quadrant pain and signs of infection.
Choice of modality:

  • Right upper quadrant abdominal ultrasonography of cholecystitis is generally the first exam of choice.[1][2][3]
  • Abdominal CT may be used if complications such as perforation or gangrene are suspected.[4] In adults, acute abdominal symptoms that are rather unspecific also indicate CT.

Gallstone

This is indicated in right upper quadrant pain without signs of infection.
Choice of modality:

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. Strasberg, SM (26 June 2008). "Clinical practice. Acute calculous cholecystitis. ". The New England Journal of Medicine 358 (26): 2804–11. doi:10.1056/nejmcp0800929. PMID 18579815. 
  2. "Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease ". Arch. Intern. Med. 154 (22): 2573–81. November 1994. doi:10.1001/archinte.154.22.2573. PMID 7979854. 
  3. "The sensitivity of hepatobiliary imaging and real-time ultrasonography in the detection of acute cholecystitis ". Arch Surg 120 (8): 904–6. August 1985. doi:10.1001/archsurg.1985.01390320028004. PMID 3893388. 
  4. Friedman L.S. (2015). Liver, Biliary Tract, & Pancreas Disorders. In Papadakis M.A., McPhee S.J., Rabow M.W. (Eds), Current Medical Diagnosis & Treatment 2015