title: Computerized tomography of the acute left upper quadrant pain.
abstract: 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.
authors.affiliation: Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd, UH 0663, Indianapolis, IN, 46202, USA. atirkes@iupui.edu.
authors.forename: Temel
authors.initials: T
authors.lastname: Tirkes
authors.affiliation: Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd, UH 0663, Indianapolis, IN, 46202, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Ballenger
authors.affiliation: Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd, UH 0663, Indianapolis, IN, 46202, USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Steenburg
authors.affiliation: Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd, UH 0663, Indianapolis, IN, 46202, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Altman
authors.affiliation: Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd, UH 0663, Indianapolis, IN, 46202, USA.
authors.forename: Kumaresan
authors.initials: K
authors.lastname: Sandrasegaran
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007479:Iopamidol
keywords: Acute abdomen; Computerized tomography; Emergency department; Left upper quadrant