CT EVALUATION OF
ACUTE ABDOMEN
DULEEKA WIJEGUNAWARDHANA
CLINICAL FELLOW IN DIAGNOSTIC RADIOLOGY
SIR CHARLES GAIRDNER HOSPITAL
ACUTE ABDOMEN
Sudden, severe abdominal pain
Unclear aetiology
Less than 24 hours
…ctd
Medical / Surgical emergency
Urgent investigations
Specific diagnosis
Prompt treatment
Causes
GIT- Appendicitis, Diverticulitis, Small bowel obstruction, Ischaemic
colitis, Bowel perforation
GUT- Ureteric calculi, Pyelonephritis
Hepato-biliary- Cholecystitis, Pancreatitis
Vascular- Abdominal aortic aneurysm, Aortic dissection,
Intra abdominal haemorrhage
IMAGING MODALITIES
Radiography
Sonography
Computed Tomography
Magnetic Resonance Imaging
Nuclear Medicine
Acute appendicitis
Perforated appendix
Acute diverticulitis
Diverticular abscess
Small Bowel Obstruction
Adhesions
Hernia
Tumour
Small Bowel Obstruction
Incarcerated right inguinal hernia
Bowel Ischaemia- Causes
Arterial or venous occlusion
Hypo-perfusion
Bowel obstruction
Bowel perforation
Duodenitis & Perforated duodenal ulcer
GUT causes
Ureteric calculus
Pyelonephritis
Ureteric calculus
Multi phasic CT
Cortico-medullary
phase
30 sec delay
Nephrographic
phase
70-90 sec delay
Excretory phase
5 min delay
Acute Pyelonephritis
Hepato-biliary system
Emphysematous
cholecystitis
Haemorrhagic
pancreatic pseudocyst
Ruptured abdominal
aortic aneurysm
Aortic dissection
Draped aorta sign
High attenuation crescent sign
Retroperitoneal Haemorrhage
On warfarin Renal tumour-AML
Helical CT
-allows rapid & cost effective evaluation of acute abdomen
PROPER TECHNIQUE & PROTOCOL