To determine the correlation between the region of abdominal tenderness determined by the
examining physician and the location of acute pathology diagnosed on abdominal CT. We
hypothesize that the acute pathology diagnosed by CT will lie within the region marked on
the abdominal wall by the examining physician prior to CT.
- All consecutive emergency department patients undergoing abdominal CT for
non-traumatic abdominal pain and tenderness will be prospectively enrolled, with the
following exceptions. For study purposes, "abdominal pain and tenderness" is defined
as pain and tenderness to direct palpation in the region anterior to the mid-axillary
line bilaterally, and extending from the costal margins to the inguinal ligaments.
Consequently, patients undergoing CT for indications such as isolated vomiting, fever
without source, staging of malignancies, isolated flank pain or suspected renal
colic, or other indications that do not meet the above definition will not be
- Pregnant women do not routinely undergo abdominal CT due to radiation concerns and
will be excluded from the study.
- Patients with altered mental status or altered abdominal sensation (due to
neurological conditions such as paraplegia) that may prevent assessment of the
location of abdominal tenderness will be excluded.
- Preverbal children will be excluded as they rarely undergo CT and will be unable to
indicate the region of maximal tenderness.