European Radiology

, Volume 20, Issue 6, pp 1414–1423 | Cite as

Thoracic causes of acute abdominal pain

  • Adriaan C. van Breda Vriesman
  • Robin H. M. Smithuis
  • Julien B. C. M. Puylaert


The origin of abdominal pain may be extra-abdominal, caused by a thoracic illness. This article illustrates the various thoracic disorders that may present with acute abdominal pain. An erroneous focus on the abdomen alone can easily lead to misdiagnosis and incorrect treatment. In cases of unexplained acute abdominal pain, radiologists should be aware of also viewing beyond the borders of the abdomen. The key to most of these thoracic diagnoses is detection of pulmonary consolidation, pleural fluid or pericardial fluid.


Ultrasound Computed tomography Acute abdomen Thorax Pulmonary embolism Pneumonia 


  1. 1.
    Duffy TP (1993) Sounds in the attic. N Eng J Med 328:44–47CrossRefGoogle Scholar
  2. 2.
    Koh DM, Burke S, Davies N, Padley PG (2002) Transthoracic US of the chest: clinical uses and applications. Radiographics 22:e1PubMedGoogle Scholar
  3. 3.
    Tapson VF (2008) Acute pulmonary embolism. N Eng J Med 358:1037–1052CrossRefGoogle Scholar
  4. 4.
    Potts DE, Sahn SA (1976) Abdominal manifestations of pulmonary embolism. JAMA 235:2835–2837CrossRefPubMedGoogle Scholar
  5. 5.
    Porcel JM, Light RW (2008) Pleural effusions due to pulmonary embolism. Curr Opin Pulm Med 14:337–342CrossRefPubMedGoogle Scholar
  6. 6.
    Patel S, Kazerooni EA (2005) Helical CT for the evaluation of acute pulmonary embolism. Am J Roentgenol 185:135–149Google Scholar
  7. 7.
    Restrepo CS, Lemos DF, Lemos JA, Velasquez E, Diethelm L, Ovella TA, Martinez S, Carrillo J, Moncada R, Klein JS (2007) Imaging findings in cardiac tamponade with emphasis on CT. Radiographics 27:1595–1610CrossRefPubMedGoogle Scholar
  8. 8.
    Donelly LF, Kimball TR, Barr LL (1999) Purulent pericarditis presenting as acute abdomen in children: abdominal imaging findings. Clin Radiol 54:691–693CrossRefGoogle Scholar
  9. 9.
    Jabr IJ (2004) Intractable vomiting as the initial presentation of pericardial effusion. Am J Emerg Med 22:624CrossRefPubMedGoogle Scholar
  10. 10.
    Famularo G, Minisola G, De Simone C (2005) Atypical cardiac tamponade mimicking acute abdomen. Am J Emerg Med 23:706–707CrossRefPubMedGoogle Scholar
  11. 11.
    Griffith JF, Rainer TH, Ching ASC (1999) Sonography compared with radiography in revealing acute rib fracture. Am J Roentgenol 173:1603–1609Google Scholar

Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Adriaan C. van Breda Vriesman
    • 1
  • Robin H. M. Smithuis
    • 1
  • Julien B. C. M. Puylaert
    • 2
  1. 1.Department of RadiologyRijnland HospitalLeiderdorpThe Netherlands
  2. 2.Department of RadiologyMCH Westeinde HospitalThe HagueThe Netherlands

Personalised recommendations