Investigating abdominal pain (summary)

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This is a basic article for medical students and other non-radiologists

Investigating abdominal pain is a common request from clinical teams throughout most hospitals. Causes of abdominal pain are vast and as such, appropriate history and examination are necessary to initiate appropriate initial management and determine appropriate investigations.

Reference article

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Summary

  • questions
    • what is the most likely cause of pain?
    • is there evidence of infection or sepsis?
    • are they haemodynamically stable?
    • are there focal signs?
    • is renal function normal?
    • are there any other blood test abnormalities that target investigation?
  • investigations
    • route of investigation depends on the question:
      • US
        • gallbladder and biliary tree
        • renal tract
        • appendicitis
      • erect CXR
        • perforation
      • AXR
        • may give some information about bowel dilatation
        • may highlight perforation and free intraperitoneal gas
        • often difficult to assess and of low yield
        • AXR use will very much depend on where you work
      • CT
        • general workhorse for much abdominal investigation
          • non-contrast for renal stones
          • portovenous phase for most work
          • arterial phase for vascular work
  • making the request
    • know what question you are trying to ask
    • know what the renal function is if the patient is for CT
    • if in doubt, as the radiologist oncall
  • common pathology
Medical student radiology curriculum