Department of Diagnostic Radiology, Tan Tock Seng Hospital
Imaging of the acute abdomen is essential to modern emergency medicine. It allows clinicians insight into the pathology that causes a patient to seek medical care. An approach based on clinical questions can be used to systematically identify imaging features that are the basis for diagnosis and treatment. By integrating the clinical presentation, specific physical findings and investigations, it is often possible to make a diagnosis. Examples of approaches based on flank pain, urinary colic, pelvic pain and scrotal disease will be presented. Correlation with other imaging modalities, including CT and MR scans will be shown. Ultrasound imaging can demonstrate both morphological features as well as velocity flow in blood vessels. Both large and medium size vessels can be evaluated. In addition, the use of Doppler indices can be helpful when looking at the effect of altered resistance to blood flow in organs. Other imaging modalities have advantages of better coverage and speed in completion of the procedure. However, ultrasound imaging can be brought close to patient and is cost effective without the drawbacks of ionizing radiation and cost associated with CT and MR scans. The appropriate choice should be customized to the local expertise and skill available.