Dr. David S. Leder, Medical Director

Did you know that abdominal pain may be felt anywhere between your stomach and groin?   Everyone has experienced pain in the abdomen at some time.   Usually it is not caused by a serious medical condition.

Pain in the abdomen can originate from:

• Organs related to digestion – the end of the esophagus, stomach, small and large intestines, liver, gall bladder, and pancreas
• The aorta – a large blood vessel that runs straight down the inside of the abdomen
• The appendix
• The kidneys – two bean-shaped organs that lie deep within the abdominal cavity

Computed Tomography (known as CT or CAT scans) and Ultrasound are extremely valuable imaging tools to assess the causes of abdominal pain and to determine the appropriate treatment when surgery is needed.

A few reasons for severe abdominal pain that may be detected by CT include:

• Appendicitis
• Bowel Obstruction
• Cholecystitis
• Pancreatitis
• Renal Stone Disease
• Diverticulitis
• Crohn’s Disease

Always consult with your physician for the best possible test in your case.

Appendicitis is an inflammation of the appendix, a small pouch attached to your large intestine, and CT is widely used for its diagnosis.  The CT scan can also show that you have an abscess from a ruptured appendix.  Typically, the first symptom is pain around your belly button. As the inflammation in the appendix increases, the pain tends to move into your right lower abdomen and focuses directly above the appendix.

Appendicitis is one of the most common causes of emergency abdominal surgery in the United States.  If you have appendicitis, your pain increases when the doctor suddenly releases the pressure after gently pressing on your lower right belly area.

Small bowel obstruction (SBO) is a common occurrence, and it is important that the site, level, severity, and cause of the obstruction be accurately determined in order for SBO to be properly treated.  CT is increasingly being utilized as the first imaging test when SBO is suspected.  Often surgery can be avoided in patients with incomplete bowel obstruction, and CT can greatly help select those for whom surgery is necessary, as well as to provide critical information in planning for surgery.  Besides confirming or excluding the diagnosis, and demonstrating the site, level, and severity of obstruction if present, CT can often allow determination of the cause and detection of complications of obstruction.

Cholecystitis is the inflammation of the gallbladder, usually resulting from gallstones blocking the cystic duct.  Typically, the pain is initially ‘colicky’ (intermittent), and becomes constant and severe.  Ultrasound is used to visualize the gallbladder and ducts, and it can also detect fluid around the gallbladder or a thickening of its wall, which are typical of acute cholecystitis.  Often, when the ultrasound probe is moved across the upper abdomen above the gallbladder, patients report tenderness.

Pancreatitis simply means inflammation of the pancreas.  Located in the upper part of the abdomen, behind the stomach, the pancreas plays an important role in digestion.  The pancreas is a gland, producing two main types of substances: digestive juices and digestive hormones.  Chronic pancreatitis causes inflammation and scarring of tissue in the pancreas.  This makes the pancreas unable to produce the right amount of chemicals (enzymes) needed to digest fat.  It also interferes with insulin production, which may lead to diabetes.  Inflammation or calcium deposits of the pancreas may be seen on an abdominal ultrasound or CT scan.  CT has also been used to evaluate and to identify patients at risk for serious complications.

Renal Stone Disease – The cause of kidney stones is the extra chemicals that are not flushed out of your system through urine and collect in the kidney.  These collected chemicals form crystals and harden into stones.  Unlike ultrasound scans, CT scans can image the entire urethra and differentiate among the various causes of urethral obstruction.  A CT scan creates a three dimensional image of structures within the body.  A particular type of CT can visualize almost all kidney stones (including those that are not seen with other imaging tests), and can determine if there is an obstruction to urine flow within the urinary tract.  This test is the best one for determining if a kidney stone is present, although it may not be necessary if a stone has been detected with another test.  Ultrasound can be used for those wishing to avoid radiation, such as pregnant women.

Diverticulitis is the swelling (inflammation) of an abnormal pouch in the intestinal wall.  Diverticulitis becomes more prevalent as people age.  Low fiber diets may play a role in this disease.  It’s important to add fiber to your diet, which helps add bulk to the stool.  Without adding fiber to the diet, the colon has to work harder than normal and this pressure may cause pouches to form weak spots.  CT offers a rapid and accurate diagnosis of diverticulitis.

Crohn’s Disease is a disorder that causes inflammation of the digestive tract and it can affect any area in the gastrointestinal (GI) tract.  Crohn’s is very similar to other intestinal disorders, such as irritable bowel syndrome and ulcerative colitis.  It can be difficult to diagnose, but through radiology tests such as CT using contrast dye it is easy to obtain images of the abdomen.  CT can help detect abscesses that might not be seen in other testing methods.

With any abdominal pain it is important to speak with your physician to determine the best course for diagnosis and treatment.  Quakerbridge Radiology has the finest caliber of physicians and we embrace the changes necessary to promote advances in radiology in order to maintain our position as frontrunners in the profession.  Inform your physician that you would like to go to Quakerbridge Radiology and call 609.890.0033 to schedule an appointment.

Each and every patient at Quakerbridge Radiology Associates receives personalized care designed to meet her individual needs.  Our staff is highly trained, our equipment is state-of-the art, and we remain committed to providing exceptional care to the women in our community.  For more information or to make an appointment, please call 609.890.0033 prompt 1 or visit our Web site www.qbradiology.com