IMAGING ASSESSMENT AND RADIOLOGICAL DIAGNOSTIC CRITERIA IN ACUTE ABDOMEN

Abstract

Acute abdomen is a serious clinical condition characterized by sudden and severe abdominal pain, accounting for 5% to 12% of emergency room admissions and associated with significant mortality (2% to 12%), which increases with delayed treatment. Due to the frequency of inconclusive clinical findings, diagnostic imaging plays a crucial role in determining the etiology and guiding therapy, being fundamental to reducing morbidity and mortality. This work consists of a narrative literature review that examines the scientific evidence on radiological evaluation in acute abdomen, using the descriptors "Abdomen, Acute" and "Radiology" in the PubMed database. Ultrasound is the initial method of choice in pediatric and pregnant patients, valued for the absence of ionizing radiation and high sensitivity for intussusception, appendicitis, and cholecystitis, although it has limitations in obese patients or those with flatulence. In contrast, Multidetector Computed Tomography (MDCT) is the gold standard for the adult population and critically ill patients, showing sensitivity and specificity greater than 90% for serious conditions such as gastrointestinal perforation, acute pancreatitis, and mesenteric ischemia. Magnetic Resonance Imaging (MRI) is an alternative for hemodynamically stable pregnant women, and plain radiography remains useful for the rapid screening of massive pneumoperitoneum and evident obstructions. Ultimate diagnostic efficacy lies in the integration of clinical data with the appropriate selection and interpretation of the imaging modality.