The diagnosis of acute abdominal pain remains hinged on the performance of a careful history and physical exam. Five to ten million emergency department visits occur each year for acute abdominal pain, creating a need to achieve improved diagnostic accuracy in an expedient fashion. Technologies such as ultrasound, computed tomography, magnetic resonance imaging, and diagnostic laparoscopy are helping achieve this goal. Of these, computed tomography appears to be the work horse of diagnostic imaging in the setting of acute abdominal pain. In this review, we examine each of these modalities, discussing their strengths and weaknesses. As well, we have reproduced an excellent algorithmic approach published by Martin and Rossi that shows the reader some basic diagnostic strategies for the evaluation of acute abdominal pain.
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