Thread by @rabihmgeha, Abdominal PainA plug for Diagnostic Efficiency.The interplay between the time course and [...]

Rabih Geha

rabihmgeha

Abdominal Pain

A plug for Diagnostic Efficiency.

The interplay between the time course and the CT.

A schema for chronic abdominal pain

And a confession...

Let's dance :)

@DxRxEdu

Abdominal PainA plug for Diagnostic Efficiency.The interplay between the time course and the CT.A schema for chronic abdominal painAnd a confession...Let's dance :) @DxRxEdu

Acute pain in the abdomen often reflects some "itis".
Appendicitis
Diverticulitis
Pancreatitis

Sometimes, the pain is vascular (ischemia) or obstructive (SBO)

All these things are readily picked up on CT with contrast.

Here is an @CPSolvers schema https://clinicalproblemsolving.com/dx-schema-abdominal-pain/

Dx Schema – Abdominal Pain

Abdominal Pain – OverviewDownload PDF hereAbdominal Pain – image-negativeDownload PDF hereCorresponding episodeEpisode 10 – Abdominal PainTweetorial #1Tweetorial #2

https://clinicalproblemsolving.com/dx-schema-abdominal-pain/

It's virtually impossible to make a gold standard Dx of acute abdominal pain without a CT.

Yeah...there are *some* exceptions

Pancreatitis
Hernia
Zoster
and a few others

And we are good at making educated guesses

But the big question often is:

Do we get a CT with contrast?

CT with contrast is the workhorse for acute abdominal pain.

CHRONIC abdominal disease?
A whole different story.

Don't get me wrong, most patients with chronic abdominal pain get a CT.

But the chances something will light up?
Not so much...in my opinion.

What's yours?

Now that you've made it this far....I have a confession.

I could have just shown you @ytk_lau Thought Train and called it a day...

Instead I took you on a dance with someone who is actually pretty shy about getting on the dance floor...

Happy Sunday, friends

Now that you've made it this far....I have a confession.I could have just shown you @ytk_lau Thought Train and called it a day...Instead I took you on a dance with someone who is actually pretty shy about getting on the dance floor...Happy Sunday, friends

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