For clinically stable patients who are not able to undergo CT and in whom the bowel is a primary diagnostic consideration, MRI without and with contrast (and in particular MR enterography) may be an alternative imaging option. US Abdomen There are no recent studies available for the evaluation of US in the setting of acute nonlocalized abdominal pain in the neutropenic patient. US may serve as a fast way of evaluating the liver, kidneys, and biliary tree, including the evaluation of HIV cholangiopathy. In the HIV-infected patient presenting with prolonged fever, one study demonstrated abdominal US successfully identifies liver lesions and splenic microabscesses in 14% of the presenting population [59]. Nuclear Medicine and FDG-PET/CT Skull Base to Mid-Thigh There are no recent studies evaluating the use of nuclear medicine imaging in the setting of acute abdominal pain in the neutropenic patient, and there are no specific indications for its use in this setting. Because of its whole Acute Nonlocalized Abdominal Pain Variant 4: Acute nonlocalized abdominal pain. Not otherwise specified. Initial imaging. The causes of nonlocalized, nontraumatic abdominal pain are extensive, and, as such, imaging needs to be broad enough to visualize the entire abdomen and pelvis, screening for visceral, solid organ, and vascular abnormalities. Imaging strategies are similar to those in patients who have concomitant fever, as many of the sources of pain overlap. CT is frequently performed first. Fluoroscopy Contrast Enema There are no recent studies evaluating the use of contrast enema imaging in the setting of nonlocalized abdominal pain, and there are no specific indications for its use in this setting. Endoscopy is the preferred initial examination of the stomach and colon in patients suspected of having inflammatory bowel disease.
Acute Nonlocalized Abdominal Pain. For clinically stable patients who are not able to undergo CT and in whom the bowel is a primary diagnostic consideration, MRI without and with contrast (and in particular MR enterography) may be an alternative imaging option. US Abdomen There are no recent studies available for the evaluation of US in the setting of acute nonlocalized abdominal pain in the neutropenic patient. US may serve as a fast way of evaluating the liver, kidneys, and biliary tree, including the evaluation of HIV cholangiopathy. In the HIV-infected patient presenting with prolonged fever, one study demonstrated abdominal US successfully identifies liver lesions and splenic microabscesses in 14% of the presenting population [59]. Nuclear Medicine and FDG-PET/CT Skull Base to Mid-Thigh There are no recent studies evaluating the use of nuclear medicine imaging in the setting of acute abdominal pain in the neutropenic patient, and there are no specific indications for its use in this setting. Because of its whole Acute Nonlocalized Abdominal Pain Variant 4: Acute nonlocalized abdominal pain. Not otherwise specified. Initial imaging. The causes of nonlocalized, nontraumatic abdominal pain are extensive, and, as such, imaging needs to be broad enough to visualize the entire abdomen and pelvis, screening for visceral, solid organ, and vascular abnormalities. Imaging strategies are similar to those in patients who have concomitant fever, as many of the sources of pain overlap. CT is frequently performed first. Fluoroscopy Contrast Enema There are no recent studies evaluating the use of contrast enema imaging in the setting of nonlocalized abdominal pain, and there are no specific indications for its use in this setting. Endoscopy is the preferred initial examination of the stomach and colon in patients suspected of having inflammatory bowel disease.