Background
Patients undergoing chest computed tomography (CT) examinations to evaluate for etiologies of thoracic symptoms, such as chest pain and dyspnea, may have upper abdominal etiologies or incidental findings that require timely diagnosis and could alter management in the acute setting. Many of these disease processes carry a significant risk of morbidity and mortality. It is therefore important to keep these entities in mind during chest CT interpretation so that patients can benefit from prompt initiation of appropriate clinical management.
Educational Goals / Teaching Points
The aim of this educational exhibit is to provide a brief review of clinically significant abdominal pathologies that may cause patients to present primarily with chest complaints and can be identified on cross-sectional thoracic imaging. The characteristic findings of these abnormalities will be illustrated through example cases.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We present a case-based review of clinically significant abdominal pathologies that were caught on chest CT or CT angiography (CTA), including gastritis, gastric ulcer, diverticulitis, cholecystitis, perforated gall bladder, hydroureteronephrosis, hepatitis, bowel obstruction, splenic infarct, abdominal aortic dissection, and pancreatitis.
Conclusion
Upper abdominal disease processes presenting with thoracic symptoms can easily be missed on chest CT. Careful inspection of the visualized abdominal structures on every examination is necessary to allow for accurate diagnosis and proper medical or surgical management.
