Orris
attachment
attachment

Pain abdomen 26 year old male

analyse_media
Reading File
Finding Sources
Finding Sources
Searching PubMed

"acute abdominal pain" AND imaging

Searching the Web

ACR Appropriateness Criteria acute nonlocalized abdominal pain radiographs free intraperitoneal air

This is a photographed erect abdominal X-ray, so interpretation is limited and it needs formal radiology review.
What is visible:
  • I do not see obvious free air under either diaphragm on this photograph, so there is no clear X-ray sign of perforated hollow viscus.
  • Bowel gas pattern does not show obvious marked small-bowel dilatation or multiple prominent air-fluid levels to strongly suggest a high-grade intestinal obstruction.
  • There may be some colonic stool/gas, but this alone does not establish constipation as the cause.
Important: A near-normal abdominal X-ray does not rule out appendicitis, renal/ureteric stone, gastritis/ulcer disease, pancreatitis, early bowel obstruction, or other important causes of abdominal pain. Plain abdominal radiographs are frequently nonspecific; for undifferentiated acute abdominal pain, contrast CT abdomen-pelvis is generally the more appropriate initial imaging study when clinically indicated, per ACR imaging guidance. This agrees with Grainger & Allison’s Diagnostic Radiology, which notes that CT or ultrasound has replaced plain abdominal radiography in most acute-abdomen settings.
Needs urgent clinical assessment now if pain is severe or worsening, especially with:
  • fever, repeated vomiting, abdominal distension
  • guarding/rigidity, inability to pass stool or flatus
  • right-lower-quadrant tenderness
  • black/bloody stool, fainting, or low urine output.
For a 26-year-old man, the next steps should be examination and targeted tests: CBC, CRP, electrolytes, urine analysis, lipase if epigastric pain, and ultrasound or CT based on pain location and examination. Free intraperitoneal air, when present, is a surgical emergency sign, but it is not evident in this image.
This is a shared conversation. Sign in to Orris to start your own chat.