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Acute abdomen of unknown origin: Impact of CT on diagnosis and management

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Abstract

A prospective study was performed including 40 patients with an acute abdominal syndrome presenting difficulties in defining the etiology. All patients underwent an emergency computed tomographic (CT) scan. The CT scan made the syndrome's diagnosis in 95% of cases and it permitted the detection of a lesion in 57.5% of cases. The diagnostic impact of CT scan was significant (p<0.01). The value and the specific contribution of CT in various diseases were analyzed. CT allowed appropriate therapeutic decisions in 95% of cases where clinical examination performance was positive in only 60% of cases. We had two negative CT results leading to an inappropriate therapeutic decision; it consisted of two cases of undiagnosed appendicitis. CT modified the primary therapeutic strategy in 30% of cases and avoided seven laparotomies.

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References

  1. Balthazar EJ, Megibow AJ, Hulnick D, Beranbaum ER. CT of appendicitis.AJR 1986;147:705–710

    PubMed  Google Scholar 

  2. Feldberg MAM, Hendriks MJ, Wanwaes PGFM. Acute appendicitis. In: Meyers MA ed.Computed tomography of the gastrointestinal tract. New York: Springer Verlag, 1986:221–234

    Google Scholar 

  3. Jeffrey RB, Federle MP, Tolentino CS. Periappendiceal inflammatory masses: CT directed management and clinical outcome in 70 patients.Radiology 1988;167:13–16

    PubMed  Google Scholar 

  4. Shapiro MP, Gale ME, Gerzof SG. CT of appendicitis. Diagnosis and treatment.Radiol Clin North Am 1989;4:753–762

    Google Scholar 

  5. Balthazar EJ, Megibow AJ, Gordon RB, Hulnick D. Caecal diverticulitis: evaluation with CT.Radiology 1987;162:79–81

    PubMed  Google Scholar 

  6. Hulnick DH, Megibow AJ, Balthazar EJ, Naidich DP, Bosniak MA. CT in the evaluation of diverticulitis.Radiology 1984;152:491–495

    PubMed  Google Scholar 

  7. Lieberman JM, Haaga JR. Computed tomography of diverticulitis.JCAT 1983;7:431–433

    Google Scholar 

  8. Megibow AJ. Diverticulitis. In: Meyers MA ed.Computed tomography of the gastrointestinal tract. New York: Springer Verlag, 1986:235–252

    Google Scholar 

  9. Neff CC, Vansonnenberg E. CT of diverticulitis: diagnosis and treatment.Radiol Clin North Am 1989;27:743–752

    PubMed  Google Scholar 

  10. Balthazar EJ, Bauman JS, Megibow AJ. CT diagnosis of closed loop obstruction.JCAT 1985;9:953–955

    Google Scholar 

  11. Balthazar EJ, Megibow AJ, Hulnick D, Naidich DP. Carcinoma of the colon: detection and preoperative staging by CT.AJR 1988;150:301–306

    PubMed  Google Scholar 

  12. Coscina WF, Arger PH, Levine MS, Herlinger H, Cohen S, Coleman BG, Mintz MC. Gastrointestinal tract focal mass lesions: role of CT and barium evaluations.Radiology 1986;158:581–587

    PubMed  Google Scholar 

  13. Jaramillo D, Raval B. CT diagnosis of primary small bowel volvulus.AJR 1986;147:941–942

    PubMed  Google Scholar 

  14. Megibow AJ, Balthazar EJ, Cho KC, Medwid SW, Birnbaum BA, Noz ME. Bowel obstruction: evaluation with CT.Radiology 1991;180:313–318

    PubMed  Google Scholar 

  15. Shaff MI, Himmelfarb E, Sacks GA, Burks DD, Kulkarni MV. The whirl sign: A CT finding in volvulus of the large bowel.JCAT 1985;9:410

    Google Scholar 

  16. Suzuki M, Tokashima T, Funaki H, Vogishi M, Isobe T, Kanno S, Ushitani K, Fuchuh K. CT diagnosis of strangulated obstruction.Eur J Radiol 1983;3:380–381

    PubMed  Google Scholar 

  17. Balthazar EJ, Megibow AJ, Siegel SE, Birnbaum BA. Appendicitis: prospective evaluation with high-resolution CT.Radiology 1991;180:21–24

    PubMed  Google Scholar 

  18. Cho KC, Morehouse HT, Alterman DD, Thornhill BA. Sigmoid diverticulitis: a diagnostic role of CT—comparison with barium enema studies.Radiology 1990;176:111–115

    PubMed  Google Scholar 

  19. Thoeni RF. CT evaluation of carcinomas of the colon and rectum.Radiol Clin North Am 1989;27:731–741

    PubMed  Google Scholar 

  20. Mueller PR, Saini S, Wittenberg J et al. Sigmoid diverticular abscesses: percutaneous drainage as an adjunct to surgical resection in 24 cases.Radiology 1987;164:321–325

    PubMed  Google Scholar 

  21. AURC, ARC. Les syndromes douloureux aigüs de l'abdomen. Etude prospective multicentrique.La Nouvelle Presse Médicale 1981;10:3771–3773

    Google Scholar 

  22. De Dombal FT. Acute abdominal pain: an omege survey.Scand J Gastroenterol 1979;14 [Suppl 56]:29–43

    Google Scholar 

  23. Jeffrey RB. CT and sonography of the acute abdomen. New York: Raven Press, 1989

    Google Scholar 

  24. Glazer GM, Buy JN, Moss AA, Goldberg HI, Federle MP. CT detection of duodenal perforation.AJR 1981;137:333–337

    PubMed  Google Scholar 

  25. Jeffrey RB, Federle MP, Wall S. Value of CT in detecting occult gastrointestinal perforation.JCAT 1983;7:825–827

    Google Scholar 

  26. Lee H, Vibhakar SD, Bellon EM. Gastrointestinal perforation: early diagnosis by computed tomography.JCAT 1983;7:226–229

    Google Scholar 

  27. ARC, AURC. Aide au diagnostic et à la décision devant un syndrome douloureux abdominal aigü.Rev Epidem et Santé Publ 1984;32:40–44

    Google Scholar 

  28. Jeffrey RB, Grendell JH, Federle MP et al. Improved survival with early CT diagnosis of pancreatic abscess.Gastrointest Radiol 1987;12:26–30

    PubMed  Google Scholar 

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Taourel, P., Baron, M.P., Pradel, J. et al. Acute abdomen of unknown origin: Impact of CT on diagnosis and management. Gastrointest Radiol 17, 287–291 (1992). https://doi.org/10.1007/BF01888571

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  • DOI: https://doi.org/10.1007/BF01888571

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