Abdominal Computed Tomography Findings in Adults with Acute Right Lower Quadrant Pain

Abstract

Acute right lower quadrant (RLQ) abdominal pain is a common symptom in patients suffering from conditions such as appendicitis, diverticulitis, or enterocolitis. Some of these are emergency conditions and often require further investigation using abdominal computed tomography (CT). The objective of this study was to evaluate CT data from adult patients with acute RLQ pain coming from various causes. Data were collected from the electronic medical records of patients aged over 15 years, who presented acute RLQ pain, at the emergency department or outpatient department, and who were then sent to receive abdominal CT scans; the data were then reviewed independently by two experienced radiologists. The final diagnosis for each patient was retrieved from surgical findings, pathological results, and medical records. Abdominal CT diagnoses were considered along with the final diagnosis and calculated as a percent. A total of 240 patients were eligible for this study. Appendicitis and related complications was the most common CT diagnoses, consisting of 160 patients (66.67%). A normal CT finding was the second most common CT diagnosis, consisting of 18 patients (7.50%). Enterocolitis was the third most common CT diagnosis, consisting of 16 patients (6.67%). Gastrointestinal (GI) cancer was the sixth most common CT diagnosis, consisting of six patients (2.50%). Fifteen cases had discordance between the CT and final diagnoses. The most common diagnoses in discordant cases was normal in CT diagnosis with enterocolitis in final diagnosis, occurring in eight patients (53.33%). The most common abdominal CT finding in adults with acute RLQ pain was appendicitis and related complications. The second most common CT finding was normal CT findings. The third most common CT finding was enterocolitis. However, acute RLQ pain can present in cases of GI cancer, the sixth most common final diagnosis. CT scans are considered useful in inconclusive clinical presentations and it must be noted that the disease may be something other than appendicitis.