Learning objectives
To describe imaging findings of uncommon causes of right lower quadrant (RLQ) acute abdominal pain,
not routinely considered in the differential diagnosis with the more common appendicitis.
Background
Acute abdominal pain accounts for up to 7-10% of all emergency department visit per year,
with RLQ pain responsible for a large percentage of these cases.
Acute appendicitis is the most common abdominal surgical emergency in the world,
with around 300000 appendicectomies performed annually in the United States.
Typically,
young patients are affected (between 10 and 20 years old),
with a lifetime risk estimated to be around 8.6% in males and 6.9% in females.
The first evaluation of a patient with RLQ pain is based...
Findings and procedure details
RLQ isexamined with ultrasound at first.
When signs of appendicitis or other peculiar features can’t be found,
CT scan with administration of contrast media,
is performed.
For its high spatial and contrast resolution,
multidetector CT is the best non-invasive technique for exploring RLQ and the whole abdomen in few seconds.
CT is the most accurate imaging modality in the diagnosis of acute appendicitis,
but also a helpful tool for the differential diagnosis of the many uncommon causes of RLQ pain.
Crohn Disease
Crohn disease (CD)...
Conclusion
It is crucial for the radiologist in the emergency department to be aware of other rare clinical conditions that present with acute abdominal pain in the right lower quadrant,
that can mimic acute appendicitis.
CT scan,
after a prior evaluation with ultrasound,
is the modality of choice for the detection of the cause of RLQ pain.
The goal is to rapidly identify emergency conditions that require surgical or conservative treatment.
Personal information
A.
G.
Tucci,
Department of Advanced Biomedical Sciences,
Diagnostic Imaging section,University of Naples "Federico II",
Naples (Italy)
Email:
[email protected]
C.
Massimo: Department of Radiology,
Santa Maria delle Grazie Hospital,
Pozzuoli (Naples,
Italy)
B.
Cusati: Department of Radiology,
Santa Maria delle Grazie Hospital,
Pozzuoli (Naples,
Italy)
M.
Di Meo: Department of Radiology,
Santa Maria delle Grazie Hospital,
Pozzuoli (Naples,
Italy)
Alfonso Ragozzino,
Department of Radiology,
Santa Maria delle Grazie Hospital,
Pozzuoli (Naples,
Italy)
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