E1416. Strange Things in Abdominal Imaging: Midnight Nightmares
  1. Natalia Andrade Goncalves; Faculdade de Medicina de Marília - FAMEMA
  2. Priscila Midori Furuta Jamus; Faculdade de Medicina de Marília - FAMEMA
  3. Helena Cristina da Silva; Faculdade de Medicina de Marília - FAMEMA
The purpose of this paper is to provide a comprehensive assessment of the imaging aspects of emergency abdominal radiology, to discuss interesting and unusual cases that appeared in our service of emergency, and offer insight on the main challenges of establishing radiologic diagnosis on CT scans.

Educational Goals / Teaching Points
Discuss the most common types of acute abdomen and the most common pathologies that may appear in the emergency service. Show classic radiological signs in abdominal imaging.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The term acute abdomen refers to any clinical condition characterized by severe abdominal pain that develops over a few hours. Many of these diseases require emergency surgical treatment. To establish the correct diagnosis and its differentials we classify acute abdomen into five general categories: inflammatory, obstructive, perfurative, hemorrhagic and ischemic. Common causes include appendicitis, diverticulitis, cholecystitis, bowel obstruction, intra-abdominal abscesses, perforated peptic ulcer, aneurism rupture, ectopic pregnancy route, twist of ovarian tumor/cyst, ovarian follicle cyst rupture. Computer tomography (CT) scans present high accuracy and is the choice of diagnosis except in cases of acute cholecystitis, although lack of delineating fat may reduce sensitivity.

Clinical assessment is often difficult, medical history can be misleading, physical examination inaccurate and laboratory test findings may be nonspecific. Rapid and accurate radiology diagnosis can be essential for the appropriate management of these acute conditions, which are not always easy.