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A variety of underlying causes may lead to the clinical symptoms of acute abdomen, which is defined by severe abdominal pain, requiring immediate treatment. Acute appendicitis, cholecystitis, bowel obstruction, acute pancreatitis, and gynecologic disease are among the most common causes. Although plain films of the abdomen are good tools to detect free intraperitoneal air and to diagnose bowel obstruction, it is much less valuable to determine the specific cause. Contrast-enhanced helical CT has been proven a very good technique for assessment of bowel obstruction. Contrast-enhanced MDCT is even more efficient to diagnose acute abdominal diseases, because it provides 3-dimensional images of the bowel. Moreover, exquisite CT-angiographic images for assessment of the mesenteric vasculature in case of suspected bowel ischemia are now possible. MDCT is a robust and very efficient technique in patients with acute abdomen. This review presents the most common causes of acute abdomen and the role of CT in its diagnosis.
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