ACT  Vol.3 No.3 , September 2014
Helical Computed Tomography in Evaluation of Selected Cases of Acute Abdomen
Abstract: Acute abdomen is a common presentation in emergency medicine. It represents 5% to 10% of all Emergency Department (ED) visits. Diagnosis by imaging includes digital X-ray unit, sonography (US) unit and computed tomography (CT) equipment. During the last years, a trend towards increased use of computed tomography in patients with acute abdomen can be seen. Additionally, patient with severe claustrophobic often cannot tolerate MR scanner. The aim of the present study was to investigate the possibility of optimizing Helical CT parameters in the protocol and emphasize the CT features of selected cases of disorders related acute abdominal complain at the Emergency Department both in general and in a number of selected conditions (Urolithiasis, Aortic Aneurysm Rupture and acute cholecystitis). According to this work findings, non-contrast CT after ultrasound is diagnostic modality for patients with urinary stones in the Emergency Department. Contrast-enhanced CT was highly sensitive for acute aortic syndrome and therefore the CT imaging protocols must be adjusted in order to minimize dose from radiation.
Cite this paper: Jastaniah, S. and Salih, A. (2014) Helical Computed Tomography in Evaluation of Selected Cases of Acute Abdomen. Advances in Computed Tomography, 3, 31-38. doi: 10.4236/act.2014.33006.

[1]   Trott, A.T. and Lucas R.H. (1998) Acute Abdominal Pain. In: Rose, P., Ed., Emergency Medicine, 4th Edition, Mosby, St. Louis, 1888-1903.

[2]   Martin, R.F. and Rossi, R.L. (1997) The Acute Abdomen: An Overview and Algorithms. Surgical Clinics of North America, 77, 1227-1243.

[3]   Clouse, W.D., Hallett Jr., J.W, Schaff H.V., et al. (2004) Acute Aortic Dissection: Population-Based Incidence Compared with Degenerative Aortic Aneurysm Rupture. Mayo Clinic Proceedings, 79, 176-180.

[4]   Olsson, C., Thelin, S., Stahle, E., Ekbom, A. and Granath, F. (2006) Thoracic Aortic Aneurysm and Dissection: Increasing Prevalence and Improved Outcomes Reported in a Nationwide Population-Based Study of More Than 14,000 Cases from 1987 to 2002. Circulation, 114, 2611-2618.

[5]   Siegel, C.L. and Cohan, R.H. (1994) CT of Abdominal Aortic Aneurysms. AJR, 163, 17-29.

[6]   Siewert, B., Raptopoulos, V., Mueller, M.F., Rosen, M.P. and Steer, M. (1997) Impact of CT on Diagnosis and Management of Acute Abdomen in Patients Initially Treated without Surgery. AJR, 168, 173-178.

[7]   Malone, A.J. (1999) Unenhanced CT in the Evaluation of the Acute Abdomen. Seminars in Ultrasound, CT and MR, 20, 68-76.

[8]   Mindelzun, R.E. and Jeffrey, R.B. (1999) The Acute Abdomen: Current CT Imaging Techniques. Seminars in Ultrasound, CT and MR, 20, 63-67.

[9]   Wang, J.H., Shen, S.H., Huang, S.S. and Chang, C.Y. (2008) Prospective Comparison of Unenhanced Spiral Computed Tomography and Intravenous Urography in the Evaluation of Acute Renal Colic. Journal of the Chinese Medical Association, 71, 30-36.

[10]   deBombal, F.T. (1991) Introduction. In: deBombal, F.T., Ed., Diagnosis of Acute Abdominal Pain, 2nd Edition, Churchill Livingstone, Edinburgh, 1-10.

[11]   Caoili, E.M., Cohan, R.H., Korobkin, M., et al. (2002) Urinary Tract Abnormalities: Initial Experience with Multi-Detector Row CT Urography. Radiology, 222, 353-360.

[12]   Johnson, E.K., Faerber, G.J., Roberts, W.W., Wolf, J.S., Park, J.M., Bloom, D.A. and Wan, J. (2011) Are Stone Protocol Computed Tomography Scans Mandatory for Children with Suspected Urinary Calculi? Urology, 78, 662-666.

[13]   Tisdale, B.E., Siemens, D.R., Lysack, J., Nolan, R.L. and Wilson, J.W. (2007) Correlation of CT Scan versus Plain Radiography for Measuring Urinary Stone Dimensions. The Canadian Journal of Urology, 14, 3489-3492.

[14]   Liu, W., Esler, S.J., Kenny, B.J., Goh, R.H., Rainbow, A.J. and Stevenson, G.W. (2000) Low-Dose Nonenhanced Helical CT of Renal Colic: Assessment of Ureteric Stone Detection and Measurement of Effective Dose Equivalent. Radiology, 215, 51-54.

[15]   Lin, W.C., Uppot, R.N., Li, C.S., Hahn, P.F. and Sahani, D.V. (2007) Value of Automated Coronal Reformations from 64-Section Multidetector Row Computerized Tomography in the Diagnosis of Urinary Stone Disease. Journal of Urology, 178, 907-911.

[16]   Adam, D.J., Bradbury, A.W., Stuart, W.P., et al. (1998) The Value of Computed Tomography in the Assessment of Suspected Ruptured Aortic Aneurysm. Journal of Vascular Surgery, 27, 431-437.

[17]   Mehard, W.B., Heiken, J.P. and Sicard, G.A. (1994) High-Attenuating Crescent in Abdominal Aortic Aneurysm Wall at CT: A Sign of Acute or Impending Rupture. Radiology, 192, 359-362.

[18]   Costello, P. and Gaa, J. (1995) Spiral CT Angiography of Abdominal Aortic Aneurysms. Radiographics, 5, 397-406.

[19]   Mackiewicz, Z., Molski, S., Szpinda, M., Jundzill, W. and Stankiewicz, W. (1998) Retroperitoneal Rupture of Abdominal Aortic Aneurysms. Journal des Maladies Vasculaires, 23, 368-370.

[20]   Fidler, J., Paulson, E.K. and Layfield, L. (1996) CT Evaluation of Acute Cholecystitis: Findings and Usefulness in Diagnosis. American Journal of Roentgenology, 166, 1085-1088.

[21]   Yamashita, K., Jin, M.J., Hirose, Y., et al. (1995) CT Findings of Transient Focal Increased Attenuation of the Liver Adjacent to the Gallbladder in Acute Cholecystitis. American Journal of Roentgenology, 164, 343-346.