Acute abdominal pain of non-traumatic origin is one of the most common causes of Emergency Department (ED) admission [1]. Acute appendicitis, diverticulitis, cholecystitis and bowel obstruction are common causes of acute abdominal pain. Other important but less frequent causes of abdominal pain include perforated viscera and bowel ischemia [2].In the ED is important rapidly identify whether the underlying cause requires an urgent or even immediate surgical intervention; indeed, acute abdominal pain can be either surgical or medical, in origin, so effective treatment is dependent upon...

From a total of 5847 patients with non-traumatic acute abdominal pain admitted to ED in 2016 who underwent US as first-line examination, we retrospectively selected the ones sent to Emergency Radiology with undetermined clinical impression, analyzing diagnostic pathway and discharge diagnosis (Fig. 1).For all patients we assessed the diagnostic issue and the clinical framework (present and past medical history, physical examination and laboratory tests).In our research, we rejected all patients with a clear issue and clinical guidelines, whereas we included patients with diffuse abdominal pain...

There were 585 (10%) US exams requested from ED physicians for patients without clear pretest suspicion. Of these, 447 (76%) had negative findings on US while in 138 patients (24%) US detected pathologies related to abdominal pain. After initial US examination 76/585 patients (13%) underwent abdominal CT: 39 patients with negative and 37 patients with positive previous US findings. According to clinical examination and laboratory tests 39 patients with negative US findings underwent CT, which confirmed negativity in 13 (true negative, TN) and detected the...

The American College of Radiology has developed clinical guidelines, the Appropriateness Criteria, based on the location of abdominal pain to help physicians choose the most appropriate imaging study. US is the initial imaging test of choice for patients presenting with right upper quadrant pain. CT is recommended for evaluating right or left lower quadrant pain, while conventional radiography has limited diagnostic value in the assessment of most patients with abdominal pain [3,8]. The value of US as a first line examination in the acute abdomen...

1. Nural MS, Ceyhan C, Baydin A et al (2008) The role of ultrasonography in the diagnosis and management of non-traumatic acute abdominal pain. Intern Emerg Med 3:349–354. DOI 10.1007/s11739-008-0157-8 2. Stoker J, van Randen A, Laméris W et al (2009) Imaging Patients with Acute Abdominal Pain. Radiology. Oct;253(1):31-46. doi: 10.1148/radiol.2531090302 3. Cartwright SL and Knudson MP (2015) Diagnostic Imaging of Acute Abdominal Pain in Adults. Am Fam Physician.2015Apr1;91(7):452-459. 4. Puylaert JB, van der Zant FM and Rijke AM (1997) Sonography and the acute abdomen:...