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RadiologyDiagnostic
Acute Abdomen Imaging Selection (ACR)
Acute Abdomen Imaging Selection (ACR): Acute Abdominal Pain → Pain Location → RLQ Approach → CT Abdomen/Pelvis IV.
Pathway Overview
10 steps
Algorithm Steps
10 total
01Start 02Decision Pain Location
- RLQ
- RUQ
- LLQ
- Epigastric
- Diffuse
03Decision RLQ Approach
- Adult
- Child/Pregnant
04End CT Abdomen/Pelvis IV
First-line adults
05Action Graded Compression US
First-line peds/pregnancy
06Action RUQ Ultrasound
First-line for biliary
07End CT Abdomen/Pelvis IV
Diverticulitis workup
08Decision Lipase Elevated?
09End CT for Complications
48-72h if severe
10Action XR then CT
Transition point, closed loop
Guideline Source
ACR Appropriateness Criteria: Acute Abdominal Pain
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- Clinical context critical for imaging selection
- Radiation concerns in young patients
- Pregnancy requires US-first approach
Applicable Regions
USAUUKEU
EU: ESR guidelines similar
US: ACR Appropriateness Criteria standard
Version 1Next review: 2028-01-01
Next steps
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Related Resources
Frequently Asked Questions
What is the Acute Abdomen Imaging Selection (ACR)?
The Acute Abdomen Imaging Selection (ACR) is a diagnostic clinical algorithm for Radiology. It provides a structured decision tree to guide clinical decision-making, based on ACR Appropriateness Criteria: Acute Abdominal Pain.
What guideline is the Acute Abdomen Imaging Selection (ACR) based on?
This algorithm is based on ACR Appropriateness Criteria: Acute Abdominal Pain (DOI: 10.1016/j.jacr.2018.09.011).
What are the limitations of the Acute Abdomen Imaging Selection (ACR)?
Known limitations include: Clinical context critical for imaging selection; Radiation concerns in young patients; Pregnancy requires US-first approach. Individual patient factors may require deviation from these recommendations.
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