Computerized tomography of the acute left upper quadrant pain

Area of Science:

• Radiology
• Emergency Medicine
• Abdominal Imaging

Background:

• Left upper quadrant (LUQ) pain is a common emergency department presentation.
• Accurate and timely diagnosis is crucial for effective patient management.
• Computerized tomography (CT) is frequently utilized for abdominal pain evaluation.

Purpose of the Study:

• To assess the clinical utility and diagnostic performance of abdominal CT scans in patients presenting with acute left upper quadrant pain.

Main Methods:

• Retrospective analysis of 100 patients presenting to the ED with LUQ pain who underwent abdominal CT.
• Comparison of CT findings with final clinical diagnoses.
• Calculation of diagnostic accuracy metrics including sensitivity, specificity, positive predictive value, and negative predictive value.

Main Results:

• CT identified acute abdominal abnormalities in 39 patients, with a sensitivity of 69%.
• Abnormal CT findings correctly identified the cause of pain in all cases (positive predictive value 100%).
• In patients with negative CT scans, 12 had clinically diagnosed pathologies missed by CT (negative predictive value 83%), while 61 had no pathology (specificity 100%).

Conclusions:

• Abdominal CT is a valuable diagnostic tool for patients with acute left upper quadrant pain in the emergency setting.
• CT demonstrates excellent specificity, effectively ruling out significant pathology when negative.
• While sensitivity is moderate, CT's high positive predictive value aids in confirming diagnoses when abnormalities are detected.