111 results on '"Abdominal Pain diagnosis"'
Search Results
2. The feasibility of deep learning-based synthetic contrast-enhanced CT from nonenhanced CT in emergency department patients with acute abdominal pain.
- Author
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Kim SW, Kim JH, Kwak S, Seo M, Ryoo C, Shin CI, Jang S, Cho J, Kim YH, and Jeon K
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain etiology, Acute Pain diagnosis, Acute Pain diagnostic imaging, Acute Pain etiology, Adult, Aged, Algorithms, Contrast Media, Feasibility Studies, Female, Humans, Male, Middle Aged, Reproducibility of Results, Abdominal Pain diagnostic imaging, Deep Learning, Emergency Service, Hospital, Radiographic Image Interpretation, Computer-Assisted methods, Tomography, X-Ray Computed methods
- Abstract
Our objective was to investigate the feasibility of deep learning-based synthetic contrast-enhanced CT (DL-SCE-CT) from nonenhanced CT (NECT) in patients who visited the emergency department (ED) with acute abdominal pain (AAP). We trained an algorithm generating DL-SCE-CT using NECT with paired precontrast/postcontrast images. For clinical application, 353 patients from three institutions who visited the ED with AAP were included. Six reviewers (experienced radiologists, ER1-3; training radiologists, TR1-3) made diagnostic and disposition decisions using NECT alone and then with NECT and DL-SCE-CT together. The radiologists' confidence in decisions was graded using a 5-point scale. The diagnostic accuracy using DL-SCE-CT improved in three radiologists (50%, P = 0.023, 0.012, < 0.001, especially in 2/3 of TRs). The confidence of diagnosis and disposition improved significantly in five radiologists (83.3%, P < 0.001). Particularly, in subgroups with underlying malignancy and miscellaneous medical conditions (MMCs) and in CT-negative cases, more radiologists reported increased confidence in diagnosis (83.3% [5/6], 100.0% [6/6], and 83.3% [5/6], respectively) and disposition (66.7% [4/6], 83.3% [5/6] and 100% [6/6], respectively). In conclusion, DL-SCE-CT enhances the accuracy and confidence of diagnosis and disposition regarding patients with AAP in the ED, especially for less experienced radiologists, in CT-negative cases, and in certain disease subgroups with underlying malignancy and MMCs., (© 2021. The Author(s).)
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- 2021
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3. Effect of Clinical Decision Support on Diagnostic Imaging for Pediatric Appendicitis: A Cluster Randomized Trial.
- Author
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Kharbanda AB, Vazquez-Benitez G, Ballard DW, Vinson DR, Chettipally UK, Dehmer SP, Ekstrom H, Rauchwerger AS, McMichael B, Cotton DM, Kene MV, Simon LE, Zhu J, Warton EM, O'Connor PJ, and Kharbanda EO
- Subjects
- Abdominal Pain etiology, Adolescent, Appendectomy, Appendicitis complications, Appendicitis diagnostic imaging, Appendicitis surgery, Child, Child, Preschool, Emergency Service, Hospital, Female, Health Care Costs statistics & numerical data, Humans, Male, Risk Assessment, Young Adult, Abdominal Pain diagnosis, Appendicitis diagnosis, Decision Support Systems, Clinical, Missed Diagnosis statistics & numerical data, Tomography, X-Ray Computed statistics & numerical data, Ultrasonography statistics & numerical data
- Abstract
Importance: Appendicitis is the most common pediatric surgical emergency. Efforts to improve efficiency and quality of care have increased reliance on computed tomography (CT) and ultrasonography (US) in children with suspected appendicitis., Objective: To evaluate the effectiveness of an electronic health record-linked clinical decision support intervention, AppyCDS, on diagnostic imaging, health care costs, and safety outcomes for patients with suspected appendicitis., Design, Setting, and Participants: In this parallel, cluster randomized trial, 17 community-based general emergency departments (EDs) in California, Minnesota, and Wisconsin were randomized to the AppyCDS intervention group or usual care (UC) group. Patients were aged 5 to 20 years, presenting for an ED visit with right-sided or diffuse abdominal pain lasting 5 days or less. We excluded pregnant patients, those with a prior appendectomy, those with selected comorbidities, and those with traumatic injuries. The trial was conducted from October 2016 to July 2019., Interventions: AppyCDS prompted data entry at the point of care to estimate appendicitis risk using the pediatric appendicitis risk calculator (pARC). Based on pARC estimates, AppyCDS recommended next steps in care., Main Outcomes and Measures: Primary outcomes were CT, US, or any imaging (CT or US) during the index ED visit. Safety outcomes were perforations, negative appendectomies, and missed appendicitis. Costs were a secondary outcome. Ratio of ratios (RORs) for primary and safety outcomes and differences by group in cost were used to evaluate effectiveness of the clinical decision support tool., Results: We enrolled 3161 patients at intervention EDs and 2779 patients at UC EDs. The mean age of patients was 11.9 (4.6) years and 2614 (44.0%) were boys or young men. RORs for CT (0.94; 95% CI, 0.75-1.19), US (0.98; 95% CI, 0.84-1.14), and any imaging (0.96; 95% CI, 0.86-1.07) did not differ by study group. In an exploratory analysis conducted in 1 health system, AppyCDS was associated with a reduction in any imaging (ROR, 0.82; 95% CI, 0.73- 0.93) for patients with pARC score of 15% or less and a reduction in CT (ROR, 0.58; 95% CI, 0.45-0.74) for patients with a pARC score of 16% to 50%. Perforations, negative appendectomies, and cases of missed appendicitis by study phase did not differ significantly by study group. Costs did not differ overall by study group., Conclusions and Relevance: In this study, AppyCDS was not associated with overall reductions in diagnostic imaging; exploratory analysis revealed more appropriate use of imaging in patients with a low pARC score., Trial Registration: ClinicalTrials.gov Identifier: NCT02633735.
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- 2021
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4. Lung base CT findings in COVID-19 adult patients presenting with acute abdominal complaints: case series from a major New York City health system.
- Author
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King MJ, Lewis S, El Homsi M, Hernandez Meza G, Bernheim A, Jacobi A, Chung M, and Taouli B
- Subjects
- Abdominal Pain etiology, Adult, Aged, Aged, 80 and over, COVID-19, Coronavirus Infections complications, Coronavirus Infections epidemiology, Female, Humans, Male, Middle Aged, New York City epidemiology, Pandemics, Pneumonia, Viral complications, Pneumonia, Viral epidemiology, Retrospective Studies, SARS-CoV-2, Abdominal Pain diagnosis, Betacoronavirus, Coronavirus Infections diagnosis, Lung diagnostic imaging, Pneumonia, Viral diagnosis, Tomography, X-Ray Computed methods
- Abstract
Objective: To describe demographic, clinical, and lung base CT findings in COVID-19 patients presenting with abdominal complaints., Methods: In this retrospective study, 76 COVID-19 patients who underwent abdominal CT for abdominal complaints from March 1 to April 15, 2020, in a large urban multihospital Health System were included. Those with positive abdominal CT findings (n = 14) were then excluded, with 62 patients undergoing final analysis (30M/32F; median age 63 years, interquartile range (IQR) 52-75 years, range 30-90 years). Demographic and clinical data were extracted. CT lung base assessment was performed by a cardiothoracic radiologist. Data were compared between discharged and hospitalised patients using Wilcoxon or Fisher's exact tests., Results: The majority of the population was non-elderly (56.4%, < 65 years) and most (81%) had underlying health conditions. Nineteen percent were discharged and 81% were hospitalised. The most frequent abdominal symptoms were pain (83.9%) and nausea/vomiting/anorexia (46.8%). Lung base CT findings included ground-glass opacities (95.2%) in a multifocal (95.2%) and peripheral (66.1%) distribution. Elevated laboratory values (when available) included C-reactive protein (CRP) (97.3%), D-dimer (79.4%), and ferritin (68.8% of males and 81.8% of females). Older age (p = 0.045), hypertension (p = 0.019), and lower haemoglobin in women (p = 0.042) were more frequent in hospitalised patients. There was no difference in lung base CT findings between discharged and hospitalised patients (p > 0.165)., Conclusions: COVID-19 patients can present with abdominal symptoms, especially in non-elderly patients with underlying health conditions. Lung base findings on abdominal CT are consistent with published reports. Radiologists should be aware of atypical presentations of COVID-19., Key Points: • COVID-19 infected patients can present with acute abdominal symptoms, especially in non-elderly patients with underlying health conditions, and may frequently require hospitalisation (81%). • There was no difference in lung base CT findings between patients who were discharged and those who were hospitalised. • Lung base CT findings included multifocal and peripheral ground-glass opacities, consistent with published reports.
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- 2020
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5. Air embolism after peripheral IV contrast injection.
- Author
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Goodwin J and Gnanapandithan K
- Subjects
- Abdominal Pain etiology, Adult, Female, Humans, Injections, Medical Illustration, Nephrolithiasis complications, Abdominal Pain diagnosis, Contrast Media adverse effects, Embolism, Air chemically induced, Nephrolithiasis diagnosis, Tomography, X-Ray Computed adverse effects
- Abstract
Competing Interests: The authors report no relevant financial relationships which, in the context of their contributions, could be perceived as a potential conflict of interest.
- Published
- 2020
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6. COVID-19 pneumonia in a Turkish child presenting with abdominal complaints and reversed halo sign on thorax CT.
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Görkem SB and Çetin BŞ
- Subjects
- Abdominal Pain etiology, Adolescent, Asymptomatic Diseases, COVID-19, COVID-19 Testing, Clinical Laboratory Techniques methods, DNA, Viral analysis, Diagnosis, Differential, Emergency Service, Hospital, Female, Humans, Pandemics, Pneumonia, Viral diagnosis, Polymerase Chain Reaction methods, Severe Acute Respiratory Syndrome diagnosis, Turkey, Abdominal Pain diagnosis, Coronavirus Infections diagnosis, Pneumonia, Viral diagnostic imaging, Severe Acute Respiratory Syndrome diagnostic imaging, Tomography, X-Ray Computed methods
- Published
- 2020
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7. Percutaneous CT-Guided Cryoablation of the Celiac Plexus: A Retrospective Cohort Comparison with Ethanol.
- Author
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Behbahani K, Chary A, Patel S, Mitchell JW, Fleishon H, and Prologo JD
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- Abdominal Pain diagnosis, Abdominal Pain epidemiology, Adult, Aged, Celiac Plexus diagnostic imaging, Celiac Plexus physiopathology, Diarrhea epidemiology, Ethanol adverse effects, Female, Humans, Incidence, Male, Middle Aged, Pain Measurement, Pain, Intractable diagnosis, Pain, Intractable epidemiology, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Abdominal Pain surgery, Celiac Plexus surgery, Cryosurgery adverse effects, Ethanol administration & dosage, Pain, Intractable surgery, Radiography, Interventional adverse effects, Tomography, X-Ray Computed adverse effects
- Abstract
Purpose: To retrospectively analyze and compare the incidence of diarrhea in patients who underwent cryoablation of the celiac plexus for intractable abdominal pain versus ethanol therapy over a 5-year period., Materials and Methods: From June 2014 to August 2019, 83 patients were identified who underwent neurolysis of the celiac plexus for management of intractable abdominal pain by using either cryoablation (n = 39 [59% female; age range, 36-79 years old [average, 60 ± 11 years old]) or alcohol (n = 44 [48% female; age range, 29-76 years old [average, 60 ± 12 years old]). Pain scores and reports of procedure-related complications or side effects, with special attention to diarrhea and/or other gastrointestinal symptoms, were collected from follow-up visits at 1 week, 1 month, and 3 months post-intervention and were compared between groups., Results: The mean time of follow-up was 17.7 days. Four patients who underwent cryoablation developed gastrointestinal symptoms consisting of 2 cases of nausea and vomiting and 2 cases of diarrhea (5.1%). Twelve patients who underwent ethanol ablation developed gastrointestinal symptoms, including 1 case of nausea, 3 cases of vomiting, and 9 cases of diarrhea (20.5%). There was a significantly higher incidence of both diarrhea (chi-squared likelihood ratio, P = .03) and overall gastrointestinal symptoms (chi-squared likelihood ratio, P = .04) in the ethanol group than in the cryoablation group., Conclusions: Cryoablation of the celiac plexus may provide a new treatment option for intractable abdominal pain, and it appears to have a lower incidence of diarrhea and fewer gastrointestinal side effects than ablation using ethanol., (Copyright © 2020 SIR. Published by Elsevier Inc. All rights reserved.)
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- 2020
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8. Elimination of oral contrast leads to faster scans in the workup of abdominal pain in the emergency setting without compromising diagnostic accuracy.
- Author
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Jun JK, Winata LS, Morrissey B, and Sutherland T
- Subjects
- Administration, Oral, Emergency Service, Hospital, Female, Humans, Image Enhancement, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Time, Triage methods, Abdominal Pain diagnosis, Abdominal Pain etiology, Contrast Media, Gastrointestinal Diseases complications, Gastrointestinal Diseases diagnostic imaging, Radiography, Abdominal methods, Tomography, X-Ray Computed methods
- Abstract
Introduction: The aim of this study was to study how the effect of eliminating oral contrast for computed tomography of the abdomen and pelvis (CTAP) in the workup of abdominal pain in the emergency department (ED) would affect the time from patient review to scan and time from review to discharge., Methods: In this retrospective study, we analysed all ED presentations with abdominal pain to our university affiliated tertiary hospital before and after a protocol that eliminated oral contrast-enhanced CTAPs were implemented in September 2018. Two equivalent periods between September and November of 2017 and 2018 were analysed. Patients were excluded if they had a history of anatomy-altering gastrointestinal surgery, history of inflammatory bowel disease, trauma, suspicion of foreign body ingestion or suspected gastrointestinal bleeding., Results: A total of 176 pre-protocol and 197 post-protocol patients were included in the study. We found that the elimination of oral contrast was associated with a decrease in mean time between ED review and scan by 110 min (379 vs. 269 min). We also found that the elimination of oral contrast did not significantly alter the pattern of radiological diagnoses seen between the two study periods, suggesting the absence of oral contrast does not affect diagnostic accuracy., Conclusion: Thus, eliminating the use of oral contrast in the workup of abdominal pain in the ED can lead to increased throughput and more timely patient care., (© 2020 The Royal Australian and New Zealand College of Radiologists.)
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- 2020
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9. Abdominal pain and access block: An unexpected audit finding.
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Herbert C, Hussey M, and Zhu W
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- Aged, Aged, 80 and over, Female, Humans, Length of Stay statistics & numerical data, Male, Medical Audit, New Zealand, Abdominal Pain diagnosis, Abdominal Pain therapy, Emergency Service, Hospital statistics & numerical data, Health Services Accessibility, Tomography, X-Ray Computed statistics & numerical data
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- 2020
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10. Endovascular Stent-Graft Repair of a Large Renal Artery Pseudoaneurysm With Impending Rupture, Arising From a Solitary Kidney.
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Vijayvergiya R, Kumar B, Budhakoty S, Savlania A, and Lal A
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- Abdominal Pain diagnosis, Adult, Female, Humans, Hypertension, Renal diagnosis, Hypertension, Renal therapy, Stents, Treatment Outcome, Aneurysm, False diagnosis, Aneurysm, False physiopathology, Aneurysm, False surgery, Angiography methods, Blood Vessel Prosthesis Implantation instrumentation, Blood Vessel Prosthesis Implantation methods, Endovascular Procedures methods, Renal Artery diagnostic imaging, Renal Artery pathology, Renal Artery surgery, Solitary Kidney diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
This was an unusual case of a large renal artery pseudoaneurysm with impending rupture, which was successfully treated with an endovascular stent-graft in a solitary kidney.
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- 2020
11. Unusual case of acute large bowel obstruction: endometriosis mimicking sigmoid malignancy.
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Sarofim M, Attwell-Heap A, Trautman J, Kwok A, and Still A
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain etiology, Acute Disease, Biopsy, Needle, Colon, Sigmoid diagnostic imaging, Colon, Sigmoid pathology, Diagnosis, Differential, Endometriosis surgery, Female, Humans, Immunohistochemistry, Intestinal Obstruction surgery, Middle Aged, Risk Assessment, Sigmoid Neoplasms diagnosis, Sigmoid Neoplasms pathology, Treatment Outcome, Colon, Sigmoid surgery, Endometriosis diagnosis, Intestinal Obstruction diagnosis, Laparotomy methods, Tomography, X-Ray Computed methods
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- 2019
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12. Laparoscopic resection of an urachal abscess caused by migration of a fish bone: a case report.
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Okada M, Emoto S, Kaneko M, Yamada D, and Nozawa H
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- Abdominal Pain diagnosis, Abdominal Pain etiology, Adult, Bone and Bones, Diagnosis, Differential, Follow-Up Studies, Foreign Bodies diagnostic imaging, Foreign-Body Migration diagnostic imaging, Humans, Male, Rare Diseases, Risk Assessment, Treatment Outcome, Urachal Cyst diagnosis, Urachal Cyst etiology, Foreign Bodies surgery, Foreign-Body Migration surgery, Laparotomy methods, Seafood adverse effects, Tomography, X-Ray Computed methods
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- 2019
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13. Contrast Enhanced Computed Tomography Revealed Gallbladder Hemorrhage Due to Active Vasculitis in a Patient With Microscopic Polyangiitis.
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Honda F, Tsuboi H, Toko H, Terasaki T, Terasaki M, Shimizu M, Ohyama A, Yagishita M, Takahashi H, Yokosawa M, Asashima H, Hagiwara S, Kondo Y, Matsumoto I, and Sumida T
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain etiology, Adrenal Cortex Hormones therapeutic use, Aged, Biopsy, Needle, Emergency Treatment, Gallbladder Diseases diagnostic imaging, Gallbladder Diseases etiology, Hemorrhage diagnostic imaging, Hemorrhage etiology, Humans, Immunohistochemistry, Male, Microscopic Polyangiitis diagnosis, Microscopic Polyangiitis drug therapy, Prognosis, Rare Diseases, Severity of Illness Index, Treatment Outcome, Cholecystectomy, Laparoscopic methods, Contrast Media, Gallbladder Diseases surgery, Hemorrhage surgery, Microscopic Polyangiitis complications, Tomography, X-Ray Computed methods
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- 2019
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14. Superior mesenteric artery syndrome in a healthy active adolescent.
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Okamoto T, Sato T, and Sasaki Y
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- Abdominal Pain diagnosis, Abdominal Pain etiology, Adolescent, Bulimia physiopathology, Diagnosis, Differential, Humans, Male, Radiographic Image Enhancement methods, Radiography, Abdominal methods, Vomiting diagnosis, Vomiting etiology, Bulimia complications, Puberty physiology, Superior Mesenteric Artery Syndrome diagnosis, Superior Mesenteric Artery Syndrome etiology, Superior Mesenteric Artery Syndrome physiopathology, Superior Mesenteric Artery Syndrome prevention & control, Tomography, X-Ray Computed methods
- Abstract
This report discusses a case of superior mesenteric artery (SMA) syndrome in a previously healthy 15-year-old boy with no weight loss or other common risk factors. The patient presented to the emergency department with acute bilious vomiting and epigastric pain after acute consumption of a meal and excessive quantities of water. The patient was diagnosed with SMA syndrome based on the findings of contrasted CT of the abdomen. In early puberty, boys have a significant increase in lean body mass and a concomitant loss of adipose tissues. These pubertal changes lead to a narrowing of the aortomesenteric space. The acute consumption of food and water caused a transient obstruction at the already-narrowed space, which resulted in the manifestation of SMA syndrome. This case demonstrates that pubertal growth spurt is a risk factor for SMA syndrome, and acute excessive ingestion can trigger SMA syndrome among those in puberty., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2019
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15. Recurrent Abdominal Pain in Systemic Lupus Erythematosus: Concurrent Lupus Enteritis and Lupus Cystitis.
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Castaño-González PA and González LA
- Subjects
- Abdominal Pain etiology, Adult, Female, Humans, Immunosuppressive Agents administration & dosage, Recurrence, Remission Induction methods, Treatment Outcome, Abdominal Pain diagnosis, Azathioprine administration & dosage, Cyclophosphamide administration & dosage, Cystitis diagnosis, Cystitis drug therapy, Cystitis etiology, Cystitis physiopathology, Enteritis diagnosis, Enteritis drug therapy, Enteritis etiology, Enteritis physiopathology, Lupus Erythematosus, Systemic complications, Lupus Erythematosus, Systemic physiopathology, Lupus Erythematosus, Systemic therapy, Methylprednisolone administration & dosage, Tomography, X-Ray Computed methods
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- 2019
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16. Emphysematous Gut.
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Bansal R, Shankar U, and Walfish A
- Subjects
- Diagnosis, Differential, Humans, Intestine, Small diagnostic imaging, Male, Middle Aged, Parenteral Nutrition methods, Prognosis, Treatment Outcome, Abdominal Pain diagnosis, Anti-Bacterial Agents administration & dosage, Laparotomy methods, Pneumatosis Cystoides Intestinalis diagnosis, Pneumatosis Cystoides Intestinalis etiology, Pneumatosis Cystoides Intestinalis physiopathology, Pneumatosis Cystoides Intestinalis therapy, Scleroderma, Systemic complications, Tomography, X-Ray Computed methods
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- 2019
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17. An unusual retroperitoneal endometriotic cyst in a young woman.
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Lu J, Zhao JY, Xiong XZ, and Cheng NS
- Subjects
- Abdominal Pain etiology, Adult, Diagnosis, Differential, Female, Humans, Immunohistochemistry, Treatment Outcome, Abdominal Pain diagnosis, Cysts diagnostic imaging, Cysts etiology, Cysts physiopathology, Cysts surgery, Dissection methods, Endometriosis diagnosis, Endometriosis physiopathology, Endometriosis surgery, Retroperitoneal Space diagnostic imaging, Retroperitoneal Space surgery, Tomography, X-Ray Computed methods
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- 2019
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18. Intraabdominal Gossypibomas with variable CT appearance: A case report.
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Fatima K
- Subjects
- Abdominal Pain etiology, Adult, Diagnosis, Differential, Female, Humans, Treatment Outcome, Ultrasonography methods, Abdominal Cavity diagnostic imaging, Abdominal Pain diagnosis, Cesarean Section adverse effects, Foreign Bodies diagnostic imaging, Foreign Bodies etiology, Foreign Bodies physiopathology, Laparotomy methods, Tomography, X-Ray Computed methods
- Abstract
A retained surgical sponge or gossypiboma is a rare and an underreported complication occurring most commonly after abdominal surgeries. The clinical presentation as well as the time of presentation is variable with about one third of patients being asymptomatic. The diagnosis is challenging because of marked variation in the presentation and imaging plays a crucial role in diagnosis. We report a 30-year old Asian woman with prior history of Caesarean section who presented with persistent abdominal pain since surgery and underwent imaging in December 2012. The case is interesting as she had two intraabdominal gossypibomas with different appearances on computerized tomography. One was suggested to be a retained foreign body while the other was initially misinterpreted as a solid ovarian mass. However, on ultrasound, both lesions showed similar appearance and the left lower abdominal solid mass was also suggested to be a retained foreign body which was then confirmed on laparotomy.
- Published
- 2019
19. Wandering Liver, Wondering Doctors!
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Matarazzo L, Mazzocco M, Gioachin A, Tagliati S, Malaventura C, and Maggiore G
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- Abdominal Pain diagnosis, Abdominal Pain etiology, Child, Preschool, Emergency Service, Hospital, Female, Humans, Liver Diseases physiopathology, Rare Diseases, Remission, Spontaneous, Risk Assessment, Vomiting diagnosis, Vomiting etiology, Watchful Waiting, Liver diagnostic imaging, Liver physiopathology, Liver Diseases diagnostic imaging, Patient Positioning, Tomography, X-Ray Computed methods
- Published
- 2018
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20. Intestinal Involvement in Kawasaki Disease.
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Colomba C, La Placa S, Saporito L, Corsello G, Ciccia F, Medaglia A, Romanin B, Serra N, Di Carlo P, and Cascio A
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- Abdominal Pain diagnosis, Abdominal Pain etiology, Adolescent, Diagnosis, Differential, Fever diagnosis, Fever etiology, Hematologic Tests methods, Hepatomegaly diagnosis, Hepatomegaly diagnostic imaging, Humans, Intestinal Diseases diagnosis, Intestinal Obstruction diagnosis, Male, Mucocutaneous Lymph Node Syndrome drug therapy, Splenomegaly diagnosis, Splenomegaly diagnostic imaging, Hospitalization, Immunoglobulins, Intravenous administration & dosage, Intestinal Diseases diagnostic imaging, Mucocutaneous Lymph Node Syndrome diagnosis, Tomography, X-Ray Computed methods
- Abstract
Objectives: To describe a case of Kawasaki disease with intestinal involvement and to analyze other published reports to define clinical characteristics, diagnostic issues, and therapeutic approaches of gastrointestinal involvement in Kawasaki disease., Study Design: A computerized search without language restriction was conducted using PubMed and SCOPUS. An article was considered eligible for inclusion in the systematic review if it reported data on patient(s) with intestinal involvement in Kawasaki disease. Our case was also included in the analysis., Results: Thirty-three articles reporting 48 cases of Kawasaki disease with intestinal involvement were considered. Fever, abdominal pain, and vomiting were the most frequent symptoms observed and typical Kawasaki disease signs and symptoms appeared after intestinal complaints in all cases. Plain radiographs, ultrasonography, and computed tomography showed pseudo-obstruction as the most frequent sign of gastrointestinal involvement; 25 patients underwent surgery. Cardiac involvement was documented in 21 cases. All but three patients received medical treatment with immunoglobulin intravenous or aspirin. The outcome was good in 28 patients; 7 patients showed persistence of coronary artery abnormalities; 1 patient developed cyanosis, and later, left hand and forefoot gangrene; 3 patients died., Conclusions: The diagnosis and treatment of Kawasaki disease might be delayed if intestinal symptoms appear before the characteristic clinical features of Kawasaki disease, thus, increasing the risk of cardiac complications. Furthermore, patients may undergo unnecessary invasive procedures. Pediatricians and pediatric surgeons, therefore, should consider Kawasaki disease among diagnoses in children with fever, abdominal symptoms, and radiologic findings of pseudo-obstruction., (Copyright © 2018 Elsevier Inc. All rights reserved.)
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- 2018
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21. [A rare and unrecognized cause of abdominal pain: epiploic appendagitis: about a case].
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Rachidi SA
- Subjects
- Aged, Colon pathology, Diagnosis, Differential, Humans, Male, Abdomen, Acute etiology, Abdominal Pain diagnosis, Colon diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
Primitive epiploic appendagites are a rare cause of acute abdomen. They often mimic acute appendicitis or diverticular sigmoiditis. Diagnosis is made during surgery. This study aims to higlight the key role of CT scan in the diagnosis of epiploic appendagitis enabling patients to avoid unnecessary surgery., Competing Interests: Les auteurs ne declarent aucun conflits d’intérêts.
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- 2018
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22. Intestinal malrotation with small bowel obstruction in an adult.
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Shenoy S
- Subjects
- Abdominal Pain diagnosis, Adult, Digestive System Abnormalities pathology, Digestive System Abnormalities surgery, Humans, Intestinal Obstruction diagnosis, Intestinal Obstruction pathology, Intestinal Volvulus pathology, Intestinal Volvulus surgery, Laparotomy methods, Male, Treatment Outcome, Digestive System Abnormalities diagnostic imaging, Intestinal Obstruction etiology, Intestinal Volvulus diagnostic imaging, Tomography, X-Ray Computed methods
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- 2018
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23. Gastrointestinal: Recurrent acute pancreatitis with a large fluid collection: Pseudocyst or else?
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Nabi Z, Singh JR, and Nageshwar Reddy D
- Subjects
- Adolescent, Diagnosis, Differential, Extravasation of Diagnostic and Therapeutic Materials diagnostic imaging, Humans, Male, Radiographic Image Enhancement methods, Recurrence, Treatment Outcome, Abdominal Pain diagnosis, Abdominal Pain etiology, Nephrostomy, Percutaneous methods, Pancreatic Pseudocyst diagnosis, Pancreatitis diagnosis, Pancreatitis physiopathology, Tomography, X-Ray Computed methods, Urinoma diagnostic imaging, Urinoma physiopathology, Urinoma surgery
- Published
- 2018
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24. A Large Abdominal Mass in a Young Man.
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Law YXT and Lee LS
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- Abdominal Pain diagnosis, Adult, Biopsy, Diagnosis, Differential, Humans, Male, Testicular Neoplasms complications, Abdominal Pain etiology, Testicular Neoplasms diagnosis, Tomography, X-Ray Computed methods
- Published
- 2018
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25. Effects of eliminating routine use of oral contrast for computed tomography of the abdomen and pelvis: A pilot study.
- Author
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Basile J, Kenny JF, Khodorkovsky B, Youssef E, Ardolic B, Chacko J, and Hahn B
- Subjects
- Abdominal Cavity diagnostic imaging, Abdominal Pain diagnostic imaging, Adult, Aged, Body Mass Index, Emergency Service, Hospital, Female, Humans, Length of Stay, Male, Middle Aged, Pilot Projects, Retrospective Studies, Abdomen diagnostic imaging, Abdominal Pain diagnosis, Clinical Protocols, Contrast Media, Pelvis diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
Introduction: Computed tomography (CT) of the abdomen and pelvis using only intravenous contrast has been shown to have a high degree of accuracy in evaluating abdominal pain. The aim of this study was to determine the effect on time to completion of study, time to radiologist read, and length of stay in the emergency department (ED) of implementing a protocol that stopped the routine use of oral contrast for CT of the abdomen and pelvis., Methods: This was a single-center, retrospective cohort study. All patients ≥18 years of age who presented to the ED and required a CT of the abdomen and pelvis during the hours 0700-1500 were included. There were two one-month study periods, before and after implementing a protocol that specified oral contrast should only be used for CT scans of the abdomen and pelvis if body mass index <25 kg/m
2 or age < 30 years, or if there was history of inflammatory bowel disease, gastrointestinal surgery, or suspected bowel malignancy., Results: During the pre- and post-implementation periods, there were 93 and 83 patients, respectively, with mean times to CT completion of 158 min and 135 min, representing a reduction of 23 min (15%). The mean lengths of stay in the pre- and post-implementation periods were 365 min and 336 min, a decrease of 29 min (8%)., Conclusion: A protocol without the routine use of oral contrast for CT of the abdomen and pelvis can result in improved time to completion and ED length of stay., (Copyright © 2018 Elsevier Inc. All rights reserved.)- Published
- 2018
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26. Pediatric appendicitis with appendicolith often presents with prolonged abdominal pain and a high risk of perforation.
- Author
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Yoon HM, Kim JH, Lee JS, Ryu JM, Kim DY, and Lee JY
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain etiology, Adolescent, Appendicitis etiology, Child, Child, Preschool, Cohort Studies, Emergency Service, Hospital, Female, Follow-Up Studies, Humans, Lithiasis diagnostic imaging, Male, Radiographic Image Enhancement, Reference Values, Retrospective Studies, Risk Assessment, Treatment Outcome, Appendectomy methods, Appendicitis diagnostic imaging, Appendicitis surgery, Lithiasis complications, Pain, Postoperative physiopathology, Tomography, X-Ray Computed methods
- Abstract
Background: Appendicolith can cause appendiceal obstruction and acute appendicitis. Its high prevalence may be related to the high perforation rate in pediatric appendicitis. This study assessed the characteristics of appendicolith and its clinical significance in pediatric appendicitis., Methods: A retrospective study was performed among children and adolescents younger than 17 years who were preoperatively diagnosed with appendicitis in the pediatric emergency department (ED). A total of 269 patients with a mean age of 9.98 ± 3.37 years were enrolled. Clinical features and contrast-enhanced computed tomography findings were analyzed., Results: Among the 269 patients, 147 (54.6%) had appendicoliths, with a mean maximal diameter of 5.21 ± 2.34 mm. Compared to the no appendicolith group, the appendicolith group demonstrated more prolonged abdominal pain (≥ 48 hours) before the ED visit (23.1% vs. 11.5%; P = 0.013), clinical features of severe appendicitis (presence of fever, vomiting, positive urine ketone, and increased C-reactive protein), and higher rate of perforation (43.5% vs. 9.8%; P < 0.001). Multivariate risk factor analysis for perforated appendicitis in the appendicolith group revealed that maximal diameter of 5 mm or more in the appendicolith (adjusted odds ratio [aOR] 2.919; 95% CI 1.325-6.428, P = 0.008) and proximal collapse adjacent to the appendicolith (aOR 2.943; 95% CI 1.344-6.443, P = 0.007) were significant., Conclusions: Pediatric appendicitis with appendicolith often presents with prolonged abdominal pain and severe clinical conditions with a high risk of perforation.
- Published
- 2018
- Full Text
- View/download PDF
27. Man With Abdominal Pain.
- Author
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Hallisey SD and Matilsky DK
- Subjects
- Abdominal Pain diagnosis, Diagnosis, Differential, Humans, Male, Wandering Spleen diagnosis, Young Adult, Abdominal Pain etiology, Tomography, X-Ray Computed methods, Wandering Spleen complications
- Published
- 2018
- Full Text
- View/download PDF
28. Elderly Woman With Abdominal Pain.
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Hwang M, Nikolla DA, Havko FC, and Carlson JN
- Subjects
- Abdominal Pain diagnosis, Aged, 80 and over, Biopsy, Diagnosis, Differential, Female, Humans, Sister Mary Joseph's Nodule diagnosis, Abdominal Pain etiology, Sister Mary Joseph's Nodule complications, Tomography, X-Ray Computed methods
- Published
- 2018
- Full Text
- View/download PDF
29. Poor Agreement Between Imaging and Histologic and Colonoscopy Findings in Pediatric Patients.
- Author
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Chapa-Rodriguez A, Bhatia T, Buckley A, Baker SS, Baker RD, and Alkhouri RH
- Subjects
- Abdominal Pain diagnosis, Adolescent, Child, Colon diagnostic imaging, Female, Humans, Male, Retrospective Studies, Sensitivity and Specificity, Colon pathology, Colonic Diseases diagnosis, Colonoscopy methods, Magnetic Resonance Imaging methods, Tomography, X-Ray Computed methods
- Abstract
Background: Computed tomography scans (CTs), more recently magnetic resonance imaging, are often used to assess the gastrointestinal tract in patients complaining of abdominal pain. We aim to determine the strength of agreement among abdominal imaging, endoscopic, and histologic findings., Methods: Retrospective chart review of pediatric patients who underwent colonoscopy between January 1, 2012, and December 31, 2014, at Women and Children's Hospital of Buffalo. Patients who had abdominal and pelvic CTs or magnetic resonance imaging within 30 days before or after a colonoscopy were included., Results: One hundred two patients were included: mean age 12.7 ± 3.8 years, 66% girls. A total of 109 imaging studies were performed. Overall 61% of imaging studies were abnormal. The most frequent intestinal radiological findings were colonic wall thickening (CWT) (55%) and colonic wall enhancement (CWH) (24%). Free fluid (20%) and fat stranding (18%) were the most common extra-intestinal findings. Imaging studies agreed with histology in 81% and with colonoscopy in 75% with a moderate strength of agreement (k: 0.59 and 0.466, respectively). CWT agreed with histology in 74% with a moderate strength of agreement (k: 0.47). History of weight loss (OR 5.35, P = 0.041), chronic diarrhea (OR 4.22, P = 0.014), a positive lactoferrin (OR 7.00, P = 0.011), and presence of CWT on imaging study (OR 5.20, P = 0.001) were predictive of having abnormal histology., Conclusions: The strength of agreement among imaging, endoscopic, and histologic findings was suboptimal. Colonoscopy and imaging are both likely to be necessary in patients with suspected inflammatory bowel disease. Although colonoscopy may be superior in diagnosis of colitis, imaging may provide more information regarding small bowel disease.
- Published
- 2018
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- View/download PDF
30. An uncommon cause of abdominal pain in a young man.
- Author
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Tan TSE and Cheah FK
- Subjects
- Abdominal Pain etiology, Adult, Colon pathology, Diagnosis, Differential, Humans, Incidence, Male, Abdominal Pain diagnosis, Colon diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
Competing Interests: We have read and understood BMJ policy on declaration of interests and declare the no competing interests.
- Published
- 2018
- Full Text
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31. Contribution of Computed Tomographic Imaging to the Management of Acute Abdominal Pain after Gastric Bypass: Correlation Between Radiological and Surgical Findings.
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Karila-Cohen P, Cuccioli F, Tammaro P, Pelletier AL, Gero D, Marmuse JP, Laissy JP, and Arapis K
- Subjects
- Abdominal Pain etiology, Abdominal Pain therapy, Acute Pain etiology, Acute Pain therapy, Adult, Diagnosis, Differential, Female, Gastric Bypass methods, Hernia, Abdominal diagnosis, Hernia, Abdominal etiology, Hernia, Abdominal therapy, Humans, Male, Mesentery surgery, Middle Aged, Obesity, Morbid diagnosis, Postoperative Complications etiology, Postoperative Complications surgery, Reoperation, Retrospective Studies, Sensitivity and Specificity, Abdominal Pain diagnosis, Acute Pain diagnosis, Gastric Bypass adverse effects, Obesity, Morbid surgery, Postoperative Complications diagnosis, Tomography, X-Ray Computed methods
- Abstract
Background: We evaluated the diagnostic accuracy of first interpretations of computed tomographic (CT) images and blind interpretation using predefined CT signs in patients with previous Roux-en-Y gastric bypass (RYGBP) and acute abdominal pain., Methods: We performed a retrospective chart review of patients with RYGBP who underwent surgical exploration from January 2009 to December 2014 for acute abdominal pain in our university institution, excluding patients without CT scan and comparing initial CT imaging interpretation with surgical findings. Two blinded radiologist specialists in bariatric imaging evaluated the CT images for seven previously reported CT signs. We then calculated the sensitivity and specificity of these signs and Cohen's kappa inter-observer agreement for diagnosing internal hernia., Results: Sixty-four patients had a recorded CT scan. The original CT interpretation showed that 26/64 (40%) patients had an accurate diagnosis. Cohen's kappa coefficient for concordance between surgical exploration and first interpretation was 0.26. The image review showed an accurate diagnosis was obtained in 51/64 patients (79.6%) and 48/64 (75%) patients for the first and second reader, respectively (Cohen's kappa coefficient = 0.67; 95% confidence interval = 0.52-0.76). The most prevalent sign indicating internal hernia was whirling of the mesentery (sensitivity = 82-91%; specificity = 79-93.1%)., Conclusions: CT is an important diagnostic tool for skilled readers for managing acute abdominal pain in patients with previous RYGBP. Experience in the abdominal and bariatric imaging and the use of predetermined CT image signs provided a high degree of accuracy and confidence. A low threshold for surgical exploration remains the gold standard of appropriate treatment.
- Published
- 2017
- Full Text
- View/download PDF
32. Laparoscopic Reduction of a Foramen of Winslow Internal Hernia Causing Transaminitis.
- Author
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Lyons R and Sayles J
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain etiology, Emergency Service, Hospital, Female, Follow-Up Studies, Humans, Middle Aged, Rare Diseases, Risk Assessment, Severity of Illness Index, Transaminases blood, Treatment Outcome, Ultrasonography, Doppler methods, Hernia, Abdominal diagnostic imaging, Hernia, Abdominal surgery, Herniorrhaphy methods, Laparoscopy methods, Tomography, X-Ray Computed methods
- Published
- 2017
33. Congenital diaphragmatic hernia manifesting after an altitude flight.
- Author
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Watanabe M, Ichimura Y, Takagaki T, and Iitsuka Y
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain etiology, Adolescent, Aircraft, Disease Progression, Female, Follow-Up Studies, Hernias, Diaphragmatic, Congenital physiopathology, Herniorrhaphy methods, Humans, Radiography, Thoracic methods, Treatment Outcome, Altitude, Hernias, Diaphragmatic, Congenital diagnostic imaging, Hernias, Diaphragmatic, Congenital surgery, Laparoscopy methods, Tomography, X-Ray Computed methods
- Published
- 2017
- Full Text
- View/download PDF
34. Role of CT in the Diagnosis of Nonspecific Abdominal Pain: A Multicenter Analysis.
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Eisenberg JD, Reisner AT, Binder WD, Zaheer A, Gunn ML, Linnau KF, Miller CM, Tramontano AC, Herring MS, Dowling EC, Halpern EF, Donelan K, Gazelle GS, and Pandharipande PV
- Subjects
- Age Distribution, Female, Humans, Male, Middle Aged, Prevalence, Reproducibility of Results, Risk Factors, Sensitivity and Specificity, Sex Distribution, United States epidemiology, Abdominal Pain diagnosis, Abdominal Pain epidemiology, Clinical Competence statistics & numerical data, Radiography, Abdominal statistics & numerical data, Tomography, X-Ray Computed statistics & numerical data
- Abstract
Objective: The objective of our study was to determine whether specific patient and physician factors-known before CT-are associated with a diagnosis of nonspecific abdominal pain (NSAP) after CT in the emergency department (ED)., Materials and Methods: We analyzed data originally collected in a prospective multicenter study. In the parent study, we identified ED patients referred to CT for evaluation of abdominal pain. We surveyed their physicians before and after CT to identify changes in leading diagnoses, diagnostic confidence, and admission decisions. In the current study, we conducted a multiple regression analysis to identify whether the following were associated with a post-CT diagnosis of NSAP: patient age; patient sex; physicians' years of experience; physicians' pre-CT diagnostic confidence; and physicians' pre-CT admission decision if CT had not been available. We analyzed patients with and those without a pre-CT diagnosis of NSAP separately. For the sensitivity analysis, we excluded patients with different physicians before and after CT., Results: In total, 544 patients were included: 10% (52/544) with a pre-CT diagnosis of NSAP and 90% (492/544) with a pre-CT diagnosis other than NSAP. The leading diagnoses changed after CT in a large proportion of patients with a pre-CT diagnosis of NSAP (38%, 20/52). In regression analysis, we found that physicians' pre-CT diagnostic confidence was inversely associated with a post-CT diagnosis of NSAP in patients with a pre-CT diagnosis other than NSAP (p = 0.0001). No other associations were significant in both primary and sensitivity analyses., Conclusion: With the exception of physicians' pre-CT diagnostic confidence, the factors evaluated were not associated with a post-CT diagnosis of NSAP.
- Published
- 2017
- Full Text
- View/download PDF
35. Trichobezoar and Rapunzel syndrome.
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Sun ZN, Hu DL, and Chen ZM
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain etiology, Bezoars physiopathology, Child, China, Contrast Media, Emergency Service, Hospital, Female, Follow-Up Studies, Humans, Laparotomy methods, Syndrome, Treatment Outcome, Bezoars diagnostic imaging, Bezoars surgery, Duodenum, Stomach, Tomography, X-Ray Computed methods
- Published
- 2017
- Full Text
- View/download PDF
36. [A woman with severe abdominal pain and endometriosis in the past].
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Schuurs TC, Vandewalle EM, and Dickhoff C
- Subjects
- Adult, Endometriosis surgery, Female, Humans, Abdominal Pain diagnosis, Hernia, Hiatal diagnostic imaging, Intestine, Small diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
A 44-year-old woman came to the emergency department with severe pain in the right upper abdomen. Her medical history mentioned a low anterior resection 8 years ago because of severe endometriosis. The CT scan showed a ruptured right hemidiaphragm with herniation of the small intestine.
- Published
- 2017
37. Initial Experience: Alleviation of Pain with Percutaneous CT-Guided Cryoablation for Recurrent Retroperitoneal Soft-Tissue Sarcoma.
- Author
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Fan WZ, Niu LZ, Wang Y, Yao XH, Zhang YQ, Tan GS, Yang JY, and Li JP
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain etiology, Adult, Aged, Analgesics therapeutic use, China, Cryosurgery adverse effects, Cryosurgery mortality, Disease-Free Survival, Feasibility Studies, Female, Humans, Kaplan-Meier Estimate, Magnetic Resonance Imaging, Male, Middle Aged, Pain Measurement, Radiography, Interventional adverse effects, Radiography, Interventional mortality, Retroperitoneal Neoplasms complications, Retroperitoneal Neoplasms diagnostic imaging, Retroperitoneal Neoplasms mortality, Retrospective Studies, Sarcoma complications, Sarcoma diagnostic imaging, Sarcoma mortality, Time Factors, Treatment Outcome, Tumor Burden, Abdominal Pain prevention & control, Cryosurgery methods, Neoplasm Recurrence, Local, Radiography, Interventional methods, Retroperitoneal Neoplasms surgery, Sarcoma surgery, Tomography, X-Ray Computed adverse effects, Tomography, X-Ray Computed mortality
- Abstract
Purpose: To evaluate the pain-alleviating effect of computed tomography (CT)-guided percutaneous cryoablation for recurrent retroperitoneal soft-tissue sarcomas (RPSs)., Materials and Methods: Data from 19 men and 20 women (median age, 50.3 y) with recurrent malignant RPS who underwent percutaneous cryoablation were reviewed retrospectively. A total of 50 tumors were treated by cryoablation, including a single tumor in 29 patients, 2 tumors in 9, and 3 tumors in 1. Adverse events and analgesic outcomes were compared as a function of tumor size (< 10 cm and ≥ 10 cm). Efficacy was assessed based on modified Response Evaluation Criteria In Solid Tumors and progression-free survival (PFS)., Results: Grade 1/2 adverse events included fever (n = 17), emesis (n = 7), frostbite (n = 5), and local pain (n = 4). The median follow-up period and PFS were 18.5 months (range, 12-42 mo) and 13.4 months ± 6.2, respectively. At the end of follow-up, 13 patients had died and 26 were living. The mean severe local pain scores on pretreatment day 1 and posttreatment days 1, 5, 10, 15, 20, and 25 were 7.49, 7.40, 6.51, 5.81, 5.35, 5.04, and 5.44, respectively, and significant differences versus pretreatment (P < .001) were reported for posttreatment days 5-25. Immediate relief occurred more frequently in the small-tumor group (4 of 7; 57.1%; P = .018), whereas delayed relief occurred more frequently in the large-tumor group (17 of 22; 77.3%; P = .030)., Conclusions: Minimally invasive percutaneous cryoablation improves local pain and is a feasible treatment for recurrent RPSs., (Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
38. Chilaiditi syndrome.
- Author
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Chen SY, Chen NF, and Lu CS
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain etiology, Conservative Treatment methods, Diagnosis, Differential, Humans, Male, Middle Aged, Treatment Outcome, Chilaiditi Syndrome diagnosis, Chilaiditi Syndrome physiopathology, Chilaiditi Syndrome therapy, Colon, Transverse diagnostic imaging, Diaphragm diagnostic imaging, Radiography, Thoracic methods, Tomography, X-Ray Computed methods
- Published
- 2016
- Full Text
- View/download PDF
39. A man with "Abdominal" pain.
- Author
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Wu Z and Wang L
- Subjects
- Cholelithiasis complications, Cholestasis complications, Drainage methods, Humans, Male, Middle Aged, Treatment Outcome, Ultrasonography, Interventional methods, Abdominal Pain diagnosis, Abdominal Pain etiology, Biliary Fistula complications, Biliary Fistula diagnostic imaging, Bronchial Fistula complications, Bronchial Fistula diagnostic imaging, Pleural Effusion diagnostic imaging, Pleural Effusion etiology, Pleural Effusion therapy, Radiography, Thoracic methods, Tomography, X-Ray Computed methods
- Published
- 2016
- Full Text
- View/download PDF
40. Intrahepatic Portal Vein Aneurysm : An Unusual Entity.
- Author
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Nayman A, Guler I, Koplay M, Erdogan H, and Cebeci H
- Subjects
- Abdominal Pain etiology, Diagnosis, Differential, Female, Humans, Liver blood supply, Middle Aged, Abdominal Pain diagnosis, Aneurysm complications, Aneurysm diagnosis, Aneurysm physiopathology, Liver pathology, Portal Vein diagnostic imaging, Portal Vein pathology, Tomography, X-Ray Computed methods, Ultrasonography, Doppler, Color methods
- Published
- 2016
41. Elderly Man With Abdominal Pain and Shortness of Breath. Tension pneumoperitoneum.
- Author
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ONeil AM and Sztajnkrycer MD
- Subjects
- Abdominal Pain diagnosis, Aged, Diagnosis, Differential, Dyspnea diagnosis, Humans, Male, Pneumoperitoneum etiology, Pneumoperitoneum surgery, Pneumoperitoneum diagnostic imaging, Tomography, X-Ray Computed
- Published
- 2016
- Full Text
- View/download PDF
42. Child With Abdominal Pain and a Cystic Pelvic Mass.
- Author
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Boelig MM, Laje P, and Peranteau WH
- Subjects
- Abdominal Pain etiology, Child, Preschool, Diagnosis, Differential, Humans, Male, Meckel Diverticulum complications, Abdominal Pain diagnosis, Meckel Diverticulum diagnosis, Tomography, X-Ray Computed methods
- Published
- 2015
- Full Text
- View/download PDF
43. RADIOLOGY REPORT: 2 cases to test your skills.
- Author
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Gibson GN and Dunn DP
- Subjects
- Adult, Contrast Media, Embolization, Therapeutic, Female, Humans, Male, Middle Aged, Torsion Abnormality complications, Torsion Abnormality diagnostic imaging, Treatment Outcome, Abdominal Pain diagnosis, Abdominal Pain etiology, Colon diagnostic imaging, Colon physiopathology, Pelvic Pain diagnosis, Pelvic Pain etiology, Tomography, X-Ray Computed methods, Ultrasonography methods, Uterus blood supply, Varicose Veins diagnosis, Varicose Veins therapy
- Published
- 2015
44. RADIOLOGY REPORT: An imaging guide to abdominal pain.
- Author
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Gray RE and Gaddey HL
- Subjects
- Age Factors, Diagnosis, Differential, Evidence-Based Medicine, Humans, Pain Management methods, Pain Measurement methods, Severity of Illness Index, Sex Factors, Abdominal Pain diagnosis, Abdominal Pain etiology, Abdominal Pain physiopathology, Magnetic Resonance Imaging methods, Radionuclide Imaging methods, Tomography, X-Ray Computed methods, Ultrasonography methods
- Abstract
When patients present with acute nontraumatic abdominal pain, knowing what disorders and which imaging modalities to consider is essential. Let this article and handy table be your guide.
- Published
- 2015
45. Impact of an emergency medicine decision support and risk education system on computed tomography and magnetic resonance imaging use.
- Author
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Carnevale TJ, Meng D, Wang JJ, and Littlewood M
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain etiology, Adult, Aged, Chest Pain diagnosis, Chest Pain etiology, Craniocerebral Trauma diagnosis, Dyspnea diagnosis, Dyspnea etiology, Electronic Health Records, Female, Fever diagnosis, Fever etiology, Headache diagnosis, Headache etiology, Humans, Lacerations diagnosis, Lower Extremity injuries, Male, Middle Aged, Neck Injuries diagnosis, Quality Improvement, Risk Assessment, Upper Extremity injuries, Uterine Hemorrhage diagnosis, Uterine Hemorrhage etiology, Young Adult, Decision Support Systems, Clinical, Emergency Service, Hospital statistics & numerical data, Magnetic Resonance Imaging statistics & numerical data, Tomography, X-Ray Computed statistics & numerical data
- Abstract
Background: Increasing computed tomography (CT) and magnetic resonance imaging (MRI) use in the emergency department (ED) over the last decade is well documented., Objective: Our aim was to assess the impact of an electronic decision support and risk education system (DS-RES) on CT/MRI use., Methods: We conducted an age-, sex-, and risk-adjusted analysis of CT/MRI use and ED and inpatient rebound rates before and after implementation in 2009 at a Kaiser Permanente Northwest medical center., Results: In the pre period, a total of 12,531 encounters occurred for unique patients within each of 10 chief complaint categories. In the post period, 16,864 total encounters occurred for unique patients within each chief complaint category, 11.4% of patients were at low risk and 24.8% and 63.8% were at medium and high risk, respectively. Adjusted CT/MRI use increased 1.1% (95% confidence interval [CI] 0%-2.3%) between pre and post periods. Among low-risk and medium-risk patients, CT/MRI use decreased by 5.0% (95% CI 2.5%-7.5%) and 10.4% (95% CI 7.9%-12.8%). Among patients at high risk, CT/MRI use increased by 3.9% (95% CI 2.5%-5.3%). The proportion of patients with a 3- or 7-day rebound to the ED or an inpatient facility decreased between pre and post periods by 1.4% (95% CI 0.7%-2.2%) and 0.7% (95% CI 0.2%-1.5%)., Conclusions: DS-RES implementation did not decrease overall CT/MRI rates, but it was associated with a shift in use toward high-risk patients and less patient rebound to the ED and hospital. Further research is required to identify mechanisms underlying imaging utilization shifts., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
46. Pyometra in a post-menopausal woman diagnosed preoperatively: a case report.
- Author
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Yahmadi A, Haoues N, Zaafouri H, Ben Maamer A, Bouhafa A, and Cherif A
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain etiology, Abdominal Pain surgery, Aged, Female, Humans, Postmenopause, Preoperative Period, Pyometra complications, Pyometra surgery, Pyometra diagnostic imaging, Tomography, X-Ray Computed methods
- Published
- 2014
47. Short answer question case series: a case of total body pain.
- Author
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Normansell D, Dalawari P, and Jang T
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain etiology, Anti-Bacterial Agents therapeutic use, Arthralgia diagnosis, Arthralgia etiology, Back Pain diagnosis, Back Pain etiology, Combined Modality Therapy, Drainage methods, Emergency Service, Hospital, Follow-Up Studies, Humans, Male, Middle Aged, Pain diagnosis, Pain etiology, Risk Assessment, Severity of Illness Index, Treatment Outcome, beta-Thalassemia diagnosis, beta-Thalassemia therapy, Psoas Abscess diagnostic imaging, Psoas Abscess therapy, Tomography, X-Ray Computed methods
- Published
- 2014
- Full Text
- View/download PDF
48. The association between advanced diagnostic imaging and ED length of stay.
- Author
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Kanzaria HK, Probst MA, Ponce NA, and Hsia RY
- Subjects
- Adolescent, Adult, Aged, Cohort Studies, Cross-Sectional Studies, Female, Humans, Least-Squares Analysis, Linear Models, Male, Middle Aged, Regression Analysis, Retrospective Studies, Young Adult, Abdominal Pain diagnosis, Back Pain diagnosis, Chest Pain diagnosis, Emergency Service, Hospital statistics & numerical data, Fever diagnosis, Headache diagnosis, Length of Stay statistics & numerical data, Magnetic Resonance Imaging statistics & numerical data, Tomography, X-Ray Computed statistics & numerical data
- Abstract
Objective: There has been a rise in advanced diagnostic imaging (ADI) use in the emergency department (ED). Increased utilization may contribute to longer length of stay (LOS), but prior reports have not considered improved methods for modeling skewed LOS data., Methods: The 2010 National Hospital Ambulatory Medical Care Survey data were analyzed by 5 common ED chief complaints. Generalized linear model (GLM) was compared to quantile and ordinary least squares (OLS) regression to evaluate the association between ADI and ED LOS. Receipt of computed tomography or magnetic resonance imaging was the primary exposure. Emergency department LOS was the primary outcome., Results: Of the 33,685 ED visits analyzed, 17% involved ADI. The median LOS for patients without ADI was 138 minutes compared to 252 minutes for those who received ADI. Overall, GLM offered the most unbiased estimates, although it provided similar adjusted point estimates to OLS for the marginal change in LOS associated with ADI. The effect of imaging differed by LOS quantile, especially for patients with abdominal pain, fever, and back symptoms., Conclusions: Generalized linear model offered an improved modeling approach compared to OLS and quantile regression. Consideration of such techniques may facilitate a more complete view of the effect of ADI on ED LOS., (Published by Elsevier Inc.)
- Published
- 2014
- Full Text
- View/download PDF
49. Crohn's disease masquerading as an acute abdomen.
- Author
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Judge J, Giordano BP, and English J
- Subjects
- Abdomen, Acute surgery, Abdominal Pain etiology, Abdominal Pain surgery, Adolescent, Crohn Disease complications, Crohn Disease surgery, Diagnosis, Differential, Disease Progression, Feeding Behavior, Follow-Up Studies, Humans, Male, Patient Education as Topic, Risk Assessment, Treatment Outcome, Abdomen, Acute diagnosis, Abdominal Pain diagnosis, Crohn Disease diagnosis, Patient Compliance statistics & numerical data, Tomography, X-Ray Computed
- Published
- 2014
- Full Text
- View/download PDF
50. Correlation of radiological investigations with clinical findings in cases of abdominal mass in the paediatric age group.
- Author
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Sharma N, Memon A, Sharma AK, Dutt V, and Sharma M
- Subjects
- Abdominal Neoplasms diagnostic imaging, Abdominal Pain diagnosis, Abdominal Pain etiology, Child, Child, Preschool, Cohort Studies, Contrast Media, Diagnosis, Differential, Female, Gastrointestinal Diseases diagnostic imaging, Humans, India, Male, Pediatrics methods, Prospective Studies, Radiography, Abdominal methods, Risk Assessment, Sensitivity and Specificity, Abdominal Neoplasms diagnosis, Gastrointestinal Diseases diagnosis, Physical Examination methods, Tomography, X-Ray Computed methods, Ultrasonography, Doppler methods
- Abstract
Background: The aim of the following study is to find out the accuracy of clinical examination and radiological investigations in determining the organ of origin and diagnosis in cases of abdominal mass., Patients and Methods: This prospective study included patients presenting with a palpable abdominal mass. Complete detailed history and clinical examination were done prior to any investigation to find out the possible clinical diagnosis and determine the organ of origin. Radiological investigations were done by blinded senior radiologist to form a radiological diagnosis and determine the organ of origin. Final diagnosis was used to see the accuracy of both the pre-operative modalities., Results: There were 50 cases which formed the study group. Male to female ratio was 2:1. Prepubescent age was the most common age group at presentation. Right hypochondrium was the most commonly affected quadrant (18%). Most of these masses were hepatobiliary in origin. The overall accuracy of ultrasound with respect to the final diagnosis was 45/50 (90%). Ultrasonography findings correlated with a clinical diagnosis in 91% of those who were operated and in 88% in those confirmed by biopsy or other modalities. Radiological investigations in total had accuracy of 94%, which was similar to the clinical examination. Both radiological diagnosis and clinical diagnosis were correct in 47/50 (94%) cases., Conclusions: Most of the cases of abdominal mass can be well evaluated clinically in terms of the diagnosis and organ of origin. Both radiological investigation and a good clinical examination have equal sensitivity. Radiological investigations are thus only adjuvant to a good clinical examination.
- Published
- 2014
- Full Text
- View/download PDF
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