CT scan of the abdomen for abdominal pain is one of the most common reasons for ordering a CT scan. Abdominal pain can be caused by many abnormalities, some of which can be diagnosed on CT. It is also very useful when the CT of the abdomen is normal because serious disease needing treatment is often excluded.
The cause of abdominal pain can often be suspected based on the location of the pain (right lower, left upper abdomen etc.). The nature of the pain such as occasional versus constant and severe. Any associated symptoms like vomiting, fever, or lab abnormalities such as an elevated white blood cell count.
In my experience, many doctors choose to confirm their suspicion for the cause of abdominal pain by ordering CT. In some cases, they think it’s nothing serious but want to make sure with a CT. CT scan for abdominal pain most commonly also covers the pelvis. Abnormalities in the pelvis can give rise to pain in the lower abdomen, or sometimes a process from the abdomen continues into the pelvis.
The CT is often done after giving contrast through the vein and after you drink oral contrast. There are some reasons that a non contrast CT will be done. This is most common if you have allergies or if the doctor has a specific diagnosis in mind such as a kidney stone which is better seen when contrast is not given.
A CT scan will be done by a technologist who operates the CT scanner and makes sure the test is done well and safely. The radiologist doctor will then interpret your scan. If your test is ordered stat, then it will be read quickly, usually in under an hour. Otherwise, it may take longer depending on the number of other cases.
Some of the more common causes of abdominal pain I see are bowel obstructions, appendicitis, diverticulitis, and kidney stones. One of the most common conclusions I reach when I see an abdominal CT scan for abdominal pain is a normal study. The cause of the abdominal pain may not be seen because it requires a different type of test to diagnose. The cause may not be seen because an organ or the bowel is not functioning properly. A CT scan can only show if something looks abnormal, not if it functions abnormally.
A CT scan of the abdomen is one component of the workup of abdominal pain. A good physician history and physical exam are critical. Both imaging and non imaging tests may be needed. Sometimes the cause is never identified or takes some time to make. CT will often help in either ruling in important causes of abdominal pain or help exclude them. Therefore, even a negative CT of the abdomen has a lot of value. In all cases, an experienced physician will be needed to combine all the known information, including CT scan of the abdomen to reach a final diagnosis.