Columbia University Irving Medical Center, Department of Radiology, 622 West 168th Street, New York, NY 10032, United States of America.
Clin Imaging. 2022 Oct;90:32-38. doi: 10.1016/j.clinimag.2022.06.015. Epub 2022 Jun 29.
Acute abdominal pain is a common cause of ED visits and often requires imaging to identify a specific diagnosis. Prompt and appropriate imaging plays a crucial role in patient management and leads to improved patient outcomes, decreased hospital stay, and improved ED workflow. There are many cases of abdominal pain in the ED with delayed diagnosis and management secondary to a combination of institutional policies and knowledge deficits in current imaging guidelines. Inappropriate use of abdominal radiographs, use of oral contrast for CT abdomen and pelvis, and concern for iodinated contrast-induced acute kidney injury are three of the more commonly encountered roadblocks to prompt imaging diagnosis of abdominal pain. The purpose of this review is to discuss why these potential causes of delayed diagnosis occur and how radiologists can help improve both imaging and ED workflow by utilizing the most up-to-date imaging guidelines such the American College of Radiology (ACR) Appropriateness Criteria and ACR Manual on Contrast Media to assist clinicians working in the emergency setting.
急性腹痛是 ED 就诊的常见原因，通常需要影像学检查来确定具体诊断。及时、恰当的影像学检查在患者管理中起着至关重要的作用，可改善患者预后，缩短住院时间，提高 ED 工作流程效率。由于机构政策和现行影像学指南知识缺陷的综合影响，ED 中有许多腹痛病例的诊断和处理被延误。腹部 X 线平片使用不当、CT 腹部和骨盆使用口服造影剂、以及对碘造影剂引起的急性肾损伤的担忧，是阻碍及时进行腹痛影像学诊断的三个较为常见的障碍。本文旨在讨论这些潜在的延误诊断原因，并探讨放射科医生如何通过利用最新的影像学指南（如美国放射学院 [ACR] 适宜性标准和 ACR 对比剂手册），帮助改善影像学检查和 ED 工作流程，为在急诊环境中工作的临床医生提供帮助。
