Welcome to Emergency Medicine Cases.com.

I'm your host us Dr. Brian

Steinhart and Dr. David Dushensky. Dr. Steinhart is an emergency physician at St. Michael's

Hospital in Toronto. He's certified in emergency medicine by the Royal College of Physicians

and Surgeons of Canada

and the American Board of Emergency Medicine.

He's a delegate for the Heart and Stroke Foundation of Canada as well as the American Heart Association,

and he's on the CME Committee at the University of Toronto Divisions of Emergency Medicine.

Dr. David Dushensky is an emergency physician at Mount Sinai Hospital in

Toronto, where he's the deputy director and quality assurance coordinator. He's a lecturer at the

University of Toronto and has won multiple postgraduate teaching awards.

Abdominal pain is the single most common reason for a visit to the ED.

While many of these patients will be discharged with the diagnosis of undifferentiated abdominal pain,

about 10% will require surgery at that visit.

There's been an ever-increasing trend of relying on imaging to diagnose the acute abdomen,

with perhaps a parallel trend towards losing clinical skills in the process, it seems at least to me. But remember that with a

really good history, physical, and interpretation of basic lab tests, we should be able to clinch

the diagnosis almost every time. Sometimes imaging can even be misleading with false positives and false negatives,

not to mention the radiation exposure and increased length of stay.

Now, don't get me wrong, CT and ultrasound technology has revolutionized the way we practice medicine

and has mostly had a positive impact on patient care.

But just like any tool,

...