CT and sonographic evaluation of acute right lower quadrant abdominal pain.
American Journal of RoentgenologyPublished 1 February 1998
Bernard A. Birnbaum, R. Brooke Jeffrey
Citations168
SJR quartileQ1
SJR score1.47
SNIP1.71
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The increased availability and use of CT and sonography have dramatically changed the clinical examination and treatment of patients who present with acute abdominal pain and these noninvasive imaging techniques have effectively replaced exploratory laparotomy as the primary means of examining patients.
Abstract
CT and sonographic evaluation of acute right lower quadrant abdominal pain.B A Birnbaum and R B Jeffrey, JrAudio Available | Share
Keywords
Medicine
RadiologyAcute appendicitis: US evaluation using graded compression.
761 Citations1986J. B. C. M. Puylaert
Ultrasound (US) examination during graded compression was performed in 60 consecutive patients with clinical signs of acute appendicitis and the inflamed appendix was visualized in 25 (89%) of 28 patients with confirmed appendix.
American Journal of RoentgenologyDiagnosis of acute flank pain: value of unenhanced helical CT.
582 Citations1996Robert C. Smith, M Verga +2 more
Unenhanced CT is a valuable technique for examining patients with acute flank pain in whom a clinical diagnosis is uncertain and can accurately determine the presence or absence of ureteral stones as well as extraurinary causes of acute flankPain.
Archives of SurgeryAppendicitis
507 Citations1975Frank R. Lewis
One thousand cases of appendicitis seen from 1963 to 1973 were reviewed and negative appendectomy rate was 20%, but in women between ages 20 and 40 it exceeded 40%, and two thirds of the negative appendectomies were due to nonsurgical lesions.
RadiologyHelical CT technique for the diagnosis of appendicitis: prospective evaluation of a focused appendix CT examination.
436 Citations1997Patrick M. Rao, James T. Rhea +5 more
New England Journal of MedicineA Prospective Study of Ultrasonography in the Diagnosis of Appendicitis
408 Citations1987J. B. C. M. Puylaert, P.H. Rutgers +5 more
It is concluded that ultrasonography is a useful aid in the diagnosis of appendicitis, which resulted in changes in the proposed management in 29 of the 111 patients and led to the correct diagnosis in the 16 patients who were found to have a disease other than appendix.
RadiologyAcute appendicitis: CT and US correlation in 100 patients.
385 Citations1994E J Balthazar, Bernard A. Birnbaum +4 more
CT is more accurate than US in diagnosis of acute appendicitis, and the results were correlated with surgical and histopathologic findings and data from other laboratory and clinical follow-up.
American Journal of RoentgenologyCT features of ulcerative colitis and Crohn's disease.
377 Citations1996R M Gore, E J Balthazar +2 more
RadiologyAppendicitis: prospective evaluation with high-resolution CT.
297 Citations1991E J Balthazar, Alec J. Megibow +2 more
In 17 of 31 patients without CT evidence of appendicitis, other conditions explaining their symptoms were detected, and when the clinical diagnosis is in doubt, CT can be used successfully to evaluate patients with acute appendiciti.
American Journal of RoentgenologyDiagnosis of acute appendicitis: value of unenhanced CT.
261 Citations1993Anthony J Malone, Christian Wolf +2 more
This study shows that unenhanced CT is a useful test to diagnose appendicitis in patients with acute abdominal pain in the right lower quadrant.
American Journal of RoentgenologyAcute ureteral obstruction: value of secondary signs of helical unenhanced CT.
259 Citations1996Robert C. Smith, M Verga +3 more
The results of this study form the basis of an imaging algorithm that can be used when interpreting unenhanced CT images of patients with acute flank pain.
RadiologyRight-sided segmental infarction of the omentum: clinical, US, and CT findings.
243 Citations1992J. B. C. M. Puylaert
American Journal of RoentgenologySonographic detection of the normal and abnormal appendix.
242 Citations1992Michel Rioux
Sonography is useful in detecting acute appendicitis and can clearly show the normal appendix more frequently than previously reported, andRuptured appendix was predicted in all cases.
RadiologyPrimary epiploic appendagitis: clinical, US, and CT findings in 14 cases.
238 Citations1994Michel Rioux, Paul Langis
Primary epiploic appendagitis has fairly characteristic US and CT features that enable a rapid diagnosis and helps confirm the presence of a fatty lesion in each patient without other inflammatory process in the abdomen.
RadiologyAcute appendicitis: high-resolution real-time US findings.
210 Citations1987R. Brooke Jeffrey, F C Laing +1 more
High-resolution, real-time ultrasonography (US) with graded compression was used to evaluate 90 patients with clinically suspected acute appendicitis and should significantly reduce the rate of false-negative appendectomies, particularly in women.
American Journal of RoentgenologyHigh-resolution sonography of acute appendicitis
195 Citations1987Monzer M. Abu‐Yousef, JJ Bleicher +4 more
High-resolution sonography was found to be accurate in the diagnosis of acute appendicitis with a specificity of 95%, a sensitivity of 80%, and an accuracy of 90%.
Diseases of the Colon & RectumDiverticular disease of the colon in Japan a review of 615 cases
187 Citations1984Kenichi Sugihara, Testuichiro Muto +3 more
Many patients with right-sided diverticulitis improved with medical treatment and the operative procedure of choice was drainage of the inflamed area with supplemental appendectomy, and the number of diverticula showed no difference between men and women.
RadiologyAppendicitis: usefulness of US in diagnosis in a pediatric population.
175 Citations1992C J Sivit, Kurt D. Newman +8 more
Results at US were positive for appendicitis in all 18 patients in the latter two categories and the initial management decision was to discharge to home or admit for observation and further testing in 18.
American Journal of RoentgenologyUnenhanced helical CT of ureteral stones: incidence of associated urinary tract findings.
168 Citations1996Douglas S. Katz, Michael J. Lane +1 more
In patients with ureteral calculi imaged with unenhanced CT for acute renal colic, associated findings included hydronephrosis, hydroureter, perinephric soft-tissue changes, and periureteral edema provided supportive evidence that an acute obstructive process was present.
RadiologyMesenteric adenitis and acute terminal ileitis: US evaluation using graded compression.
165 Citations1986J. B. C. M. Puylaert
In a patient with acute pain in the right lower quadrant whose appendix cannot be visualized sonographically and whose US findings consist of enlarged mesenteric lymph nodes and mural thickening of the terminal ileum, the diagnosis is probably mesenterics adenitis and acute terminal ILEitis.
American Journal of RoentgenologyOvarian torsion in prepubertal and pubertal girls: sonographic findings.
147 Citations1994James E. Stark, Marilyn J. Siegel
Sonographic findings of ovarian torsion vary with age, and color Doppler signal can be documented in many twisted ovaries in prepubertal and pubertal girls.
American Journal of RoentgenologySonographic diagnosis of perforation in patients with acute appendicitis.
144 Citations1990K F Borushok, R. Brooke Jeffrey +2 more
It is suggested that in patients without a sonographically visible appendix, recognition of loculated pericecal fluid and prominent pericescal fat may be a useful indirect clue to the diagnosis of perforating appendicitis.
RadiologyDistal ureteral calculi: detection with vaginal US.
133 Citations1994F C Laing, Carol B. Benson +4 more
In symptomatic female patients, use of vaginal sonography should be considered to evaluate the distal ureter for calculi, particularly if the results of transabdominal examination are normal or inconclusive.
RadiologyAppendicitis: use of arrowhead sign for diagnosis at CT.
122 Citations1997Patrick M. Rao, J Wittenberg +3 more
The arrowhead sign is an often present, highly specific sign of appendicitis that can add specificity to the diagnosis of right lower-quadrant inflammatory processes at CT.
RadiologyUltrasound versus excretory urography in evaluating acute flank pain.
119 Citations1985F C Laing, R. Brooke Jeffrey +1 more
Although US is an effective screening modality for hydronephrosis in patients with chronic renal obstruction, it is not useful for evaluating patients with acute flank pain in whom acute obstruction may be present.
Academic Emergency MedicineAbdominal Pain in Geriatric Emergency Patients: Variables Associated with Adverse Outcomes
112 Citations1998Catherine A. Marco, Charles N. Schoenfeld +3 more
The majority of geriatric emergency patients with abdominal pain have significant disease necessitating hospital admission, and specific variables are strongly associated with death and the need for surgical intervention.
RadiologyAppendicitis: efficacy of color Doppler sonography.
112 Citations1994S P Quillin, M J Siegel
Blood flow in the appendiceal wall or right lower quadrant mass on color Doppler US scans suggests appendicitis, but absence of flow cannot definitively distinguish a normal from an abnormal appendix.
American Journal of RoentgenologyComputed tomography of neutropenic colitis
110 Citations1984MP Frick, C. W. Maile +3 more
Clinical improvement and return of adequate numbers of functioning neutrophils coincided with decrease in cecal wall thickening on CT, and prompt radiologic recognition of this serious condition is crucial.
RadiologyCT diagnosis of mesenteric adenitis.
109 Citations1997Patrick M. Rao, James T. Rhea +1 more
Mesenteric adenitis is an important clinical mimic of appendicitis and appears at CT as clustered, enlarged mesenteric lymph nodes with a normal appendix, and there may be associated ileitis or ileocolitis noted.
Journal of Ultrasound in MedicineColor Doppler sonography of adnexal torsion.
108 Citations1995Arthur C. Fleischer, Sharon M. Stein +2 more
The color Doppler sonographic features in 13 patients with surgically proved adnexal torsion that help determine whether or not the ovaries were viable or nonviable at the time of surgery are presented.
American Journal of RoentgenologySonographic diagnosis of acute appendicitis: interpretive pitfalls.
108 Citations1994R. Brooke Jeffrey, Kiran A. Jain +1 more
A number of imaging pitfalls must be kept in mind when sonograms of the right lower quadrant are interpreted and important limitations and areas of interpretive difficulty in sonography for appendicitis are illustrated.
The American Journal of SurgeryDifferential diagnosis of appendicitis and pelvic inflammatory disease
103 Citations1985Fred Bongard, Daniel V. Landers +1 more
The history and physical findings reported herein provide a number of criteria which, when taken together, will usually allow a confident diagnosis of either appendicitis or pelvic inflammatory disease to be made.
American Journal of RoentgenologyThe spectrum of sonographic findings in hemorrhagic ovarian cysts
101 Citations1987O H Baltarowich, AB Kurtz +4 more
Hemorrhagic ovarian cysts should be included in the differential diagnosis of any adnexal mass that has good sound through-transmission, signifying the basic cystic nature of the lesion.
PubMedCT of appendicitis and diverticulitis.
97 Citations1994Birnbaum Ba, Balthazar Ej
The current role of CT scans in the diagnosis and management of patients with gastrointestinal disorders associated with perienteric inflammatory extension is reviewed.
The American Journal of SurgeryNegative findings at appendectomy
97 Citations1984W. Y. Lau, Irene Oi‐Lin Ng +3 more
Patients with negative appendectomy should be regularly followed up to 1 year, since 9.3 percent of patients had a diagnosis made later by investigation, and 12.1 percent had moderate to severe pain on follow-up.
RadiologyEctopic pregnancy: evaluation with endovaginal color flow imaging.
96 Citations1992John S. Pellerito, Kenneth J. W. Taylor +5 more
The addition of color Doppler flow imaging to endovaginal sonography allows increased sensitivity in the detection of ectopic pregnancy.
RadiologyCampylobacter ileocolitis mimicking acute appendicitis: differentiation with graded-compression US.
89 Citations1988J. B. C. M. Puylaert, Roy Lalisang +2 more
In nine patients with clinical symptoms of acute appendicitis, graded-compression ultrasound (US) did not depict the appendix but instead demonstrated mural thickening of the terminal ileum and part of the colon, as well as moderately enlarged mesenteric lymph nodes.
RadiologyAppendicitis: usefulness of color Doppler US.
87 Citations1996Hyo Keun Lim, W J Lee +4 more
A simple additional color Doppler US examination may be helpful in the diagnosis of early acute appendicitis when an appendix is well depicted and is equivocal in size at gray-scale US.
RadiologyPeriappendiceal inflammatory masses: CT-directed management and clinical outcome in 70 patients.
84 Citations1988R. Brooke Jeffrey, Michael P. Federle +1 more
The outcome was reviewed in 70 patients with computed tomographic (CT) and clinical evidence of periappendiceal inflammatory masses; clinical resolution of the inflammatory process occurred in 28 patients; and nine of ten patients underwent early surgical drainage for extensive, poorly defined abscesses.
RadiologySelf-localization in US of appendicitis: an addition to graded compression.
78 Citations1993Richard M. Chesbrough, T K Burkhard +3 more
A method of self-localization was added to the standard graded-compression examination of acute appendicitis in an effort to expedite the sonographic evaluation and improve diagnostic accuracy.
American Journal of RoentgenologySonographic evaluation of ectopic pregnancy: an update.
78 Citations1995Mary C. Frates, F C Laing
This review addresses the use of state-of-the-art sonography to evaluate patients with possible ectopic pregnancy and the role of color and pulsed Doppler imaging is discussed.
American Journal of RoentgenologySonography in patients with suspected acute appendicitis: value in establishing alternative diagnoses
76 Citations1989E H Gaensler, R. Brooke Jeffrey +2 more
It is suggested that sonography is useful in establishing alternative diagnoses in patients undergoing sonography for suspected acute appendicitis, and suggested the correct diagnosis in 57 patients.
Journal of Computer Assisted TomographyCT in Adnexal Torsion with Emphasis on Tubal Findings
72 Citations1994M. Ghossain, Jean‐Noël Buy +8 more
Thickening of the fallopian tube with hemorrhage could be detected by CT and is suggestive of torsion especially if associated with an adnexal mass.
Journal of Computer Assisted TomographyEpiploic Appendicitis
66 Citations1986Kelvin S. Danielson, Mark M. Chernin +3 more
In the setting of acute abdominal pain the location and focal nature of the inflammatory process as seen on CT may allow the radiologist to suggest the correct diagnosis.
World Journal of SurgeryAcute and perforated appendicitis: Current experience with ultrasound‐aided diagnosis
59 Citations1990Wolf B. Schwerk, Britta Wichtrup +2 more
The clinical value of high-resolution real-time sonography for the diagnosis of acute and complicated appendicitis was prospectively investigated in 857 patients admitted with suspected appendiciti and the ultrasound findings were correlated with history and physical examination on admission.
American Journal of RoentgenologySonographic diagnosis of neutropenic typhlitis
58 Citations1987SA Teefey, MA Montana +2 more
Sonography appears to be a useful tool not only to detect typhlitis in patients with symptoms suggestive of the disease, but also to follow their clinical course.
American Journal of RoentgenologyCT of the acute abdomen: findings and impact on diagnosis and treatment.
54 Citations1994Bettina Siewert, V Raptopoulos
An acute abdomen is a clinical condition characterized by severe abdominal pain that develops suddenly over several hours or less, and some cases require immediate surgical treatment, whereas for others, surgery is unnecessary or contraindicated.
The American Journal of SurgeryHigh-resolution real-time ultrasonography
54 Citations1988David Adams, Calliope Fine +1 more
It is suggested that ultrasonographic evaluation may be of particular use in selected patients who do not demonstrate the classical signs and symptoms of acute appendicitis.
Journal of Computer Assisted TomographyComputed Tomography of the Abnormal Appendix
53 Citations1988Emil J. Balthazar, Alec J. Megibow +3 more
The CT features of 29 abnormal appendices visualized during abdominal CT examinations are described to establish the source of the abdominal pathology and helps greatly in the differential diagnosis.
Journal of Computer Assisted TomographyCT Appearance of Appendicitis and Its Local Complications
52 Citations1985M. Elon Gale, Steven Birnbaum +4 more
Five cases are presented in which CT provided clinically useful information supplementing that gained from barium studies and clinical presentation, when a periappendiceal lesion is found.
Journal of Computer Assisted TomographyCT Detection of Typhlitis
47 Citations1985G. Williams Adams, Robert F. Rauch +3 more
A case of typhlitis (neutropenic colitis) is reported in which the initial diagnosis was suggested by CT, and radiologists performing CT should be aware of this potentially lethal complication of leukemia.
The American Journal of SurgerySpontaneous segmental infarction of the greater omentum
46 Citations1980David D. Crofoot
No convincing etiology has yet been advanced although blunt trauma, whether substantial or trivial, may account for some cases and the close temporal and geographic relation of two of these cases has raised the question of infectious etiology; however there was no microbiologic or pathologic evidence of bacterial or viral infection.
American Journal of RoentgenologyUncomplicated acute diverticulitis of the cecum and ascending colon: sonographic findings in 18 patients.
43 Citations1990Mitsuyoshi Wada, Yujiro Kikuchi +1 more
It is indicated that the major sonographic finding in patients with uncomplicated acute diverticulitis of the right colon is a hypoechoic round or oval focus protruding from a segmentally thickened colonic wall.
RadiologyCecal diverticulitis: evaluation with CT.
36 Citations1987E J Balthazar, Alec J. Megibow +2 more
Computed tomographic examinations in seven patients with cecal diverticulitis and barium studies, available in four patients, led to a correct diagnoses of diverticULitis in two cases.
Journal of Clinical UltrasoundDoppler ultrasound findings in tubo‐ovarian infectious complex
34 Citations1993Helena Tinkanen, Erkki Kujansuu
Ten women with tubo‐ovarian infectious complex caused by pelvic inflammatory disease were investigated with vaginal Doppler sonography during the acute and healing phase of the infection, and a low resistance blood flow was found at the margin of the infectious complex.
RadiologyCrohn disease of the ileocecal region: US visualization of the appendix.
31 Citations1988J. B. C. M. Puylaert, S D van der Werf +2 more
In three of 52 consecutive patients with a painful mass in the right lower quadrant, ultrasound (US) disclosed severe mural thickening of the terminal ileum and cecum and moderate mural thickened of the appendix.
Journal of Computer Assisted TomographyComputed Tomography and Appendiceal Abscess
30 Citations1983Bronwyn Jones, Elliot K. Fishman +1 more
Five cases are presented in which appendiceal abscesses were demonstrated by computed tomography (CT) and confirmed at surgery, and three of the patients were elderly, with an atypical presentation; in these, CT was especially important in clarifying the diagnosis by including appendix abscess in the differential diagnosis of pelvic pathology.
Abdominal ImagingCT demonstration of the appendix in asymptomatic adults
29 Citations1989John C. Scatarige, David J. DiSantis +2 more
Analysis of variance revealed no statistically significant correlation between a CT-demonstrated appendix and the four variables examined, and the appendix was definitely visualized in only 45 of the 103 patients (43.7%).
Journal of Computer Assisted TomographyCT of the Normal Appendix
29 Citations1991Scott Grosskreutz, Walter B. Goff +2 more
Conventional CT techniques were utilized and the normal appendix was definitely identified in 51% of the patients studied, and potential pitfalls are described.
Journal of Computer Assisted TomographyCT Findings in Tuboovarian Abscess
27 Citations1991James H. Ellis, Isaac R. Francis +3 more
CT from seven patients with nine TOAs was retrospectively reviewed, finding that the most common appearance of these abscesses was that of a somewhat tubular septated cystic pelvic mass with uniform wall thickness and with loss of fat planes between the mass and the adjacent pelvic organs.
American Journal of RoentgenologyCecal diverticulitis differentiated from appendicitis using graded-compression sonography
22 Citations1989R. Reid Townsend, R. Brooke Jeffrey +1 more
The Journal of PediatricsApplications of new imaging modalities to the evaluation of common pediatric conditions
9 Citations1999Richard M. Heller, Marta Hernanz‐Schulman