Computerized tomography of the acute left upper quadrant pain

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• 作者：Temel Tirkes ; Zachary Ballenger ; Scott D. Steenburg…
• 刊名：Emergency Radiology
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：23
• 期：4
• 页码：353-356
• 全文大小：230 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Emergency Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1438-1435
• 卷排序：23

文摘

The purpose of this study was to evaluate the clinical utility of computerized tomography (CT) of the abdomen in the emergent setting of left upper quadrant pain. One hundred patients (average age: 45, range: 19–93 years, female: 57 %, male: 43 %) who presented to the emergency department (ED) and underwent CT scanning of abdomen with the given indication of left upper quadrant pain were included in this study. The results from CT examinations were compared to final diagnoses determined by either ED physician or clinician on a follow-up visit. Sensitivity of CT was 69 % (95 %CI: 52–83 %) for 39 patients who eventually were diagnosed with an acute abdominal abnormality. Twenty-seven patients had an acute abnormal finding on abdominal CT that represented the cause of the patient’s pain (positive predictive value of 100 %, 95 %CI: 87–100 %). Of the remaining 73 patients with negative CT report, 12 were diagnosed clinically (either in the ED or on follow-up visit to specialist) with a pathology that was undetectable on the CT imaging (negative predictive value of 83 %, 95 %CI: 73–91 %). None of the remaining 61 patients with negative CT were found to have pathology by clinical evaluation (specificity of 100 %, 95 %CI: 94–100 %). CT is a useful examination for patients with acute left upper quadrant pain in the emergency department setting with moderate sensitivity and excellent specificity.KeywordsLeft upper quadrantAcute abdomenComputerized tomographyEmergency department