Abdominal Pain? Here Are the Top 10 Causes Seen on Your CT - And the Most Common Misdiagnoses

Abdominal Pain? Here Are the Top 10 Causes Seen on Your CT — And the Most Common Misdiagnoses

Abdominal pain is one of the most common reasons people visit the emergency room. Often, doctors will order a CT scan of the abdomen and pelvis to look for the cause. Unfortunately, not every diagnosis is straightforward, and not every radiology report gets it right the first time. At MDView, we see how valuable a second opinion from a subspecialized body imaging radiologist who specializes in imaging of the abdomen and pelvis can be in avoiding unnecessary procedures or catching what was missed.

Here are the top 10 causes of abdominal pain commonly diagnosed on CT, and the misdiagnoses we see most often.

1. Appendicitis

  • What CT Shows: Enlarged appendix, wall thickening, surrounding inflammation

  • Often Misdiagnosed As: Gastroenteritis or ovarian pain, especially in women or elderly patients

  • Why It Matters: Delayed diagnosis can lead to rupture

2. Diverticulitis

  • What CT Shows: Inflamed colon with diverticula and fat stranding

  • Often Misdiagnosed As: Appendicitis or cancer

  • Why It Matters: Misdiagnosis can lead to unnecessary surgery or missed abscesses

3. Kidney Stones

  • What CT Shows: Calcified stones, often with ureteral dilation

  • Often Misdiagnosed As: Musculoskeletal back pain or gastrointestinal issues

  • Why It Matters: Missed stones can cause severe obstruction and infection

4. Gallstones or Cholecystitis

  • What CT Shows: Gallbladder inflammation, stones, wall thickening

  • Often Misdiagnosed As: Gastritis, pancreatitis, or even cardiac pain

  • Why It Matters: Infections like cholecystitis can become life-threatening

5. Bowel Obstruction

  • What CT Shows: Dilated loops of bowel, transition point

  • Often Misdiagnosed As: Constipation or gastroenteritis

  • Why It Matters: Delayed diagnosis can lead to bowel ischemia and surgery

6. Pancreatitis

  • What CT Shows: Swollen pancreas, surrounding fat stranding or fluid

  • Often Misdiagnosed As: Ulcers or gallbladder disease

  • Why It Matters: Missed pancreatitis may go untreated or be mistaken for cancer

7. Ovarian Cyst or Torsion (in women)

  • What CT Shows: Enlarged ovary or cystic lesion, sometimes missed without pelvic imaging

  • Often Misdiagnosed As: Appendicitis or UTI

  • Why It Matters: Ovarian torsion requires emergency surgery to save the ovary

8. Hernia

  • What CT Shows: Bowel or fat protruding through abdominal wall

  • Often Misdiagnosed As: Muscle strain or soft tissue mass

  • Why It Matters: Strangulated hernias can be life-threatening if untreated

9. Liver or Spleen Injury (especially after trauma)

  • What CT Shows: Lacerations, hematomas, or active bleeding

  • Often Misdiagnosed As: Simple contusions if not carefully reviewed

  • Why It Matters: Internal bleeding can be subtle but dangerous

10. Inflammatory Bowel Disease (Crohn’s/Colitis)

  • What CT Shows: Wall thickening, mucosal enhancement, fat stranding

  • Often Misdiagnosed As: Infectious colitis or IBS

  • Why It Matters: A misread scan can delay important long-term treatment

When Misreads Happen: The Case for a Second Opinion

CT scans are excellent tools, but not all radiologists are abdominal imaging experts. In emergency settings, general radiologists may be reading hundreds of diverse exams under time pressure. This can lead to missed findings, wrong assumptions, or lack of clinical correlation.

At MDView, our board-certified body imaging radiologists specialize in interpreting abdominal and pelvic imaging only. We regularly identify:

  • Early tumors that were dismissed as “inflammation”

  • Small abscesses or leaks missed in the ER

  • Subtle signs of torsion, ischemia, or vascular conditions

The Bottom Line

If you’re dealing with unresolved abdominal pain, confusing CT results, or a diagnosis that doesn’t quite fit your symptoms, a second opinion from a subspecialized radiologist can provide clarity and peace of mind.

Upload your CT scan to MDView for a fast, expert second opinion in 72 hours or less. Don't have your exam? No problem! MDView can get your exam on your behalf at no cost to you! Just register for an account and click the Have MDView Get My Exam button on your homepage.

Visit https://app.mdview.com to get started today!

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