The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Epigastric Pain are nonspecific and overlap with other conditions [6]. GERD questionnaires, esophageal manometry, esophageal pH testing, imaging examinations, and upper endoscopy are routinely used for diagnosis [6]. PUD has an incidence of 0.1% to 0.3% [7]. Early diagnosis, treatment of Helicobacter pylori infections, and widespread use of proton pump inhibitors have all led to reducing the prevalence of PUD. It is still important to diagnose PUD, because PUD-related complications can be seen in 2% to 10% of cases, and PUD-related perforation is a surgical emergency with a mortality rate of up to 30% [7,8]. Although endoscopy is considered the standard test of choice for diagnosing these entities, patients may present with nonspecific symptoms, which may lead to an imaging study in which these entities could be identified. CT Abdomen and Pelvis Although a CT examination is not the test of choice for initial imaging if acid reflux, esophagitis, gastritis, peptic ulcer, or duodenal ulcer is strongly suspected, patients with these entities may present with nonspecific/overlapping symptoms and may undergo a CT abdomen and pelvis as the initial diagnostic test for evaluation [7].
Epigastric Pain. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Epigastric Pain are nonspecific and overlap with other conditions [6]. GERD questionnaires, esophageal manometry, esophageal pH testing, imaging examinations, and upper endoscopy are routinely used for diagnosis [6]. PUD has an incidence of 0.1% to 0.3% [7]. Early diagnosis, treatment of Helicobacter pylori infections, and widespread use of proton pump inhibitors have all led to reducing the prevalence of PUD. It is still important to diagnose PUD, because PUD-related complications can be seen in 2% to 10% of cases, and PUD-related perforation is a surgical emergency with a mortality rate of up to 30% [7,8]. Although endoscopy is considered the standard test of choice for diagnosing these entities, patients may present with nonspecific symptoms, which may lead to an imaging study in which these entities could be identified. CT Abdomen and Pelvis Although a CT examination is not the test of choice for initial imaging if acid reflux, esophagitis, gastritis, peptic ulcer, or duodenal ulcer is strongly suspected, patients with these entities may present with nonspecific/overlapping symptoms and may undergo a CT abdomen and pelvis as the initial diagnostic test for evaluation [7].