Imaging the acute abdomen in adults

There are around 600,000 emergency admissions under the care of general surgeons each year in England and 50% of them present with abdominal pain. An acute abdomen is defined as severe, persistent abdominal pain that requires urgent surgical or medical review. It can be due to a range of causes, from benign and self-limiting to life-threatening surgical emergencies. Imaging has been shown to have a positive effect on the accuracy of the clinical diagnosis to lead to changes in decisions about management, and to increase the level of diagnostic certainty in patients. It also has a role to play in easing the ever-increasing pressure of limited hospital beds by allowing faster and safer discharge where necessary. This article summarises the main imaging options and findings in the most common and urgent clinical scenarios involving the acute abdomen. A widely accepted and practised view is that the choice of imaging should be guided by the location of pain.

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