What is the major differential diagnosis for acute abdominopelvic conditions that can be diagnosed on CT and MRI?
This is a broad but important differential diagnosis, with representative etiologies as follows.
- • Inflammatory/infectious causes include acute hepatitis; acute cholecystitis; acute cholangitis; acute pancreatitis; acute pyelonephritis; peptic ulcer disease; acute infectious or inflammatory gastritis, enteritis, or colitis; acute diverticulitis; acute appendicitis; mesenteric lymphadenitis; peritonitis; epiploic appendagitis; segmental omental infarction; pelvic inflammatory disease (PID); abdominal or pelvic abscess; and Fournier gangrene.
- • Vascular causes include solid organ or neoplasm infarction; bowel (mesenteric) ischemia/infarction; hemorrhage (whether spontaneous or into a cyst or neoplasm); abdominal aortic aneurysm (AAA) rupture; abdominal aortic dissection or penetrating aortic ulcer; acute vascular occlusion; and adnexal torsion.
- • Traumatic causes include solid organ injury; hollow organ injury; and vascular injury.
- • Other causes include hollow organ (bowel, biliary tree, urothelial system) obstruction; bowel perforation; solid organ rupture; cyst or neoplasm rupture; abdominal compartment syndrome (ACS); and ectopic pregnancy.