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Previous Volume 348:236-242 January 16, 2003 Number 3 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

An otherwise healthy 22-year-old woman comes to the emergency department with acute abdominal pain of 18 hours' duration in the right lower quadrant. On physical examination, she is afebrile, with tenderness on deep palpation in the right lower quadrant, and has no peritoneal signs. Pelvic examination reveals tenderness in the right adnexa without a mass. How should this patient be further evaluated?

The Clinical Problem

. . . [Full Text of this Article]

Strategies and Evidence

History and Physical Examination

Laboratory Testing

Observation and Laparoscopy

Conventional Radiography

Ultrasonography

Computed Tomography

Computed Tomography versus Ultrasonography

Effect of Imaging on Outcome

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Departments of Radiology (E.K.P.) and Surgery (M.F.K., T.N.P.), Duke University Medical Center, Durham, N.C.

Address reprint requests to Dr. Paulson at the Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710, or at pauls003@mc.duke.edu.

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