What is the Diagnostic Utility of an Abdominal CT Scan in the Hospitalized Medical Patient With Nonspecific Abdominal Pain?

Acute epiploic appendagitis (EA) is a rare and often misdiagnosed cause of acute abdominal pain. Though a benign and often self-limiting condition, EA's ability to mimic other disease processes makes it an important consideration in patients presenting with acute abdominal symptoms. Careful evaluation of abdominal CT scan findings is crucial in the accurate diagnosis of epiploic appendagitis, thus avoiding unnecessary surgical intervention. We report a case of a 29-year-old male presenting with a two day history of generalized abdominal pain. Physical exam revealed a diffusely tender abdomen with hypoactive bowel sounds. The patient had a leukocytosis of 18,000 and abdominal CT scan revealed right lower quadrant inflammatory changes suggestive of acute appendicitis. Laparoscopic exploration revealed an inflamed gangrenous structure adjacent to the ileocecal junction. Pathologic evaluation revealed tissue consistent with epiploic appendagitis. Retrospective review of the CT scan revealed a normal appearing appendiceal structure superolateral to the area of inflammation. The patient recovered uneventfully with resolving leukocytosis. We present a case of cecal epiploic appendagitis mimicking acute appendicitis and review the current literature on radiographic findings, diagnosis, and treatment of this often misdiagnosed condition. General surgeons should be aware of this self-limiting condition and consider this in the differential diagnosis.

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Omental infarction following colonoscopy

Journal of Digestive Endoscopy ◽

10.4103/0976-5042.159243 ◽

2015 ◽

Vol 06 (02) ◽

pp. 073-075

Author(s):

Antonio Gangemi ◽

Aqsa Durrani ◽

Brian R. Boulay

Keyword(s):

Abdominal Pain ◽

Ct Scan ◽

Acute Abdominal Pain ◽

Abdominal Ct ◽

Lower Quadrant ◽

Omental Infarction ◽

Abdominal Ct Scan ◽

The Right ◽

Inflammatory Changes ◽

Right Lower Quadrant

AbstractDiagnosis of omental infarction, while rare, has become increasingly common likely due to improvements in diagnostic imaging. Reported incidence of omental infarction varies; however, omental infarction has not yet been described in association with colonoscopy. Common complications of colonoscopy include complications of sedation, complications of bowel preparation, and bleeding following polypectomy, and rarely, perforation or infection. We describe herein a case of a 63-year-old female who developed acute right lower quadrant abdominal pain following a colonoscopy. Abdominal computed tomography (CT) scan revealed omental infarction in the right lower quadrant. Conservative management was employed, and the patient was observed for resolution of symptoms. Repeat abdominal CT scan 2 weeks following initial presentation showed resolution of inflammatory changes associated with omental infarction. The patient also improved clinically. Omental infarction should be considered in patients presenting with acute abdominal pain following colonoscopy.

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TRAUMA GINJAL

Jurnal Radiologi Indonesia ◽

10.33748/jradidn.v4i1.89 ◽

2020 ◽

Vol 4 (1) ◽

pp. 52-57

Author(s):

Noflih Sulistia ◽

Bambang Soeprijanto ◽

Indrastuti Normahayu ◽

Lenny Violetta

Keyword(s):

Ct Scan ◽

Pediatric Patients ◽

Radiological Examination ◽

Renal Trauma ◽

Abdominal Ct ◽

Abdominal Ct Scan

Renal trauma in children is more common than in adults. Clinically in pediatric patients with renal trauma do not always describe the degreeof trauma. Radiological examination, especially abdominal CT-scan with contrast, can help evaluate the damage to the kidneys so that it candetermine the degree of trauma.

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Study on the Radiation Dose of Abdominal CT Scan Using Dual Energy

Korean Society of Computed Tomographic Technology ◽

10.31320/jksct.2018.20.2.123 ◽

2018 ◽

Vol 20 (2) ◽

pp. 123-132

Author(s):

Dae-hyun Park ◽

Young-Kyoon Kim ◽

Jong-Ho Ahn ◽

Kwang-Hyun Chang ◽

Yoon-Chul Nam ◽

...

Keyword(s):

Radiation Dose ◽

Ct Scan ◽

Dual Energy ◽

Abdominal Ct ◽

Abdominal Ct Scan

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A Rare Case of Bilateral Incarcerated Obturator Hernias and a Right-Side Femoral Hernia

10.31487/j.jscr.2020.01.03 ◽

2020 ◽

pp. 1-3

Author(s):

Jinping Xu ◽

Ruth Wei ◽

Salieha Zaheer

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Femoral Hernia ◽

Rare Case ◽

Hernia Recurrence ◽

High Morbidity ◽

Diagnostic Challenge ◽

Abdominal Ct ◽

Abdominal Ct Scan ◽

History Of

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.

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Splenic abscess caused by Streptococcus anginosus bacteremia secondary to urinary tract infection: a case report and literature review

Open Medicine ◽

10.1515/med-2020-0117 ◽

2020 ◽

Vol 15 (1) ◽

pp. 997-1002

Author(s):

Hao Wu ◽

Rui Zheng

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Ct Scan ◽

Splenic Abscess ◽

Low Density ◽

Abdominal Ct ◽

Streptococcus Anginosus ◽

Abdominal Ct Scan ◽

Tract Infections

AbstractOrgan abscesses caused by Streptococcus anginosus are relatively rare. We report the case of an elderly woman with splenic abscess caused by S. anginosus bacteremia after urinary tract infection. An 82-year-old woman had a history of frequency of urination, urgency, and fever with chills for over 10 days prior to admission. An abdominal computed tomography (CT) scan performed in the emergency room revealed a low-density lesion in the spleen, kidney cysts, some exudation around the kidney, and cystitis should be valued. She was treated with ceftriaxone and imipenem/cilastatin. After admission, the blood culture yielded positive results for S. anginosus. A contrast-enhanced abdominal CT scan showed that the low-density lesion previously found in the spleen was smaller than before. After percutaneous drainage of the splenic abscess and treatment with piperacillin/tazobactam based on the antibiotic sensitivity pattern, repeated abdominal CT scan revealed a significant reduction in the low-density lesion. The patient was discharged without recurrence or complications. A systematic review of organ abscess caused by S. anginosus bacteremia was performed. To our knowledge, there has been no report of splenic abscess caused by S. anginosus bacteremia secondary to urinary system tract infection, although urinary tract infections are also an important source.

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Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

BMC Gastroenterology ◽

10.1186/s12876-021-01627-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhicheng Zhang ◽

Xiaowei Huang ◽

Qian Chen ◽

Demin Li ◽

Qi Zhou ◽

...

Keyword(s):

Small Intestine ◽

Case Report ◽

Literature Review ◽

Ct Scan ◽

Duplication Cyst ◽

Abdominal Ct ◽

Case Presentation ◽

Abdominal Ct Scan ◽

Capsule Endoscopes

Abstract Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

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Comparative analysis of the radiation shield effect in an abdominal CT scan

Journal of the Korean Physical Society ◽

10.3938/jkps.64.929 ◽

2014 ◽

Vol 64 (6) ◽

pp. 929-935

Author(s):

Seon-Chil Kim ◽

Young-Jae Kim ◽

Joon-Seok Lee ◽

Kyung-Rae Dong ◽

Woon-Kwan Chung ◽

...

Keyword(s):

Comparative Analysis ◽

Ct Scan ◽

Radiation Shield ◽

Abdominal Ct ◽

Abdominal Ct Scan

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Selective non-operative management of anterior abdominal stab wounds with emphasis on the value of follow-up abdominal CT scanning

Trauma ◽

10.1177/1460408617706389 ◽

2017 ◽

Vol 20 (3) ◽

pp. 194-202

Author(s):

El Yamani Fouda ◽

Alaa Magdy ◽

Sameh Hany Emile

Keyword(s):

Ct Scan ◽

Ct Scanning ◽

Operative Management ◽

Abdominal Ct ◽

Management Group ◽

Abdominal Ct Scan ◽

Laparotomy Group ◽

Abdominal Stab Wounds ◽

Non Operative Management

Background and aim Selective non-operative management of patients with penetrating abdominal stabs is the preferred treatment strategy. The present study aimed to assess the efficacy and safety of non-operative management with emphasis on the value of follow-up abdominal CT scanning in management of patients with penetrating anterior abdominal stab. Patients and methods This is a retrospective chart review of stable patients with anterior abdominal stab wounds. Patients were divided in terms of initial decisions into two groups: laparotomy group and non-operative management group. Abdominal CT scan was performed for patients in the non-operative management group on admission and follow-up CT scanning was performed in cases of clinical and/or biochemical deterioration. Results The laparotomy group included 82 patients and 68.2% of them had unnecessary laparotomies. The non-operative management group comprised 97 patients and 90.7% of them did not require subsequent laparotomy. Abdominal CT scan had a sensitivity of 88.9% and specificity of 100% in detection of intra-abdominal injuries. Follow-up CT scanning detected bowel injuries missed by initial CT scan in three patients. The non-operative management group had significantly lower post-operative complication rate than the laparotomy group (4.1% vs. 18.3%), with a significantly shorter length of stay. Conclusions Non-operative management is the optimal management strategy for stable patients with penetrating anterior abdominal stab to decrease unnecessary laparotomy rates, hospital stay and costs. Follow-up abdominal CT scanning facilitated the decision making for patients selected for non-operative management and is highly sensitive in the diagnosis of patients who require subsequent exploration.

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