Duodenal emergencies: utility of multidetector CT with 2D multiplanar reconstructions for challenging but critical diagnoses

Emerg Radiol. 2020 Apr;27(2):195-203. doi: 10.1007/s10140-019-01735-7. Epub 2019 Dec 14.

Abstract

Duodenal pathology is an infrequent cause of acute abdominal pain for which patients present to the emergency department. Critical pathology on multidetector CT (MDCT) may be overlooked if the radiologist does not carefully evaluate the duodenum as part of the search pattern. Optimal MDCT protocols include intravenous contrast with multiplanar reconstructions (MPRs). A variety of etiologies ranging from infection to malignancy can involve the duodenum, for which interrogation with MPRs is most helpful given the anatomy and complex relationship with surrounding structures. The purpose of this review article is to highlight the importance of CT acquisition with multiplanar reconstructions and review the spectrum of emergent duodenal pathology, with the goal of ensuring accurate and timely diagnosis to best guide patient management.

Keywords: Abdominal pain; Acute abdomen; Duodenum; Multidetector CT; Multiplanar reconstruction.

Publication types

  • Review

MeSH terms

  • Abdominal Pain / diagnostic imaging*
  • Contrast Media
  • Duodenal Diseases / diagnostic imaging*
  • Emergency Service, Hospital
  • Humans
  • Multidetector Computed Tomography / methods*

Substances

  • Contrast Media