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ACR Appropriateness Criteria® Epigastric Pain.

Publication ,  Journal Article
Expert Panel on Gastrointestinal Imaging, ; Vij, A; Zaheer, A; Kamel, IR; Porter, KK; Arif-Tiwari, H; Bashir, MR; Fung, A; Goldstein, A; Kobi, M ...
Published in: J Am Coll Radiol
November 2021

Epigastric pain can have multiple etiologies including myocardial infarction, pancreatitis, acute aortic syndromes, gastroesophageal reflux disease, esophagitis, peptic ulcer disease, gastritis, duodenal ulcer disease, gastric cancer, and hiatal hernia. This document focuses on the scenarios in which epigastric pain is accompanied by symptoms such as heartburn, regurgitation, dysphagia, nausea, vomiting, and hematemesis, which raise suspicion for gastroesophageal reflux disease, esophagitis, peptic ulcer disease, gastritis, duodenal ulcer disease, gastric cancer, or hiatal hernia. Although endoscopy may be the test of choice for diagnosing these entities, patients may present with nonspecific or overlapping symptoms, necessitating the use of imaging prior to or instead of endoscopy. The utility of fluoroscopic imaging, CT, MRI, and FDG-PET for these indications are discussed. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Duke Scholars

Published In

J Am Coll Radiol

DOI

EISSN

1558-349X

Publication Date

November 2021

Volume

18

Issue

11S

Start / End Page

S330 / S339

Location

United States

Related Subject Headings

  • United States
  • Societies, Medical
  • Nuclear Medicine & Medical Imaging
  • Magnetic Resonance Imaging
  • Humans
  • Fluoroscopy
  • Evidence-Based Medicine
  • Abdominal Pain
  • 3202 Clinical sciences
  • 1117 Public Health and Health Services
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Expert Panel on Gastrointestinal Imaging, ., Vij, A., Zaheer, A., Kamel, I. R., Porter, K. K., Arif-Tiwari, H., … Carucci, L. R. (2021). ACR Appropriateness Criteria® Epigastric Pain. J Am Coll Radiol, 18(11S), S330–S339. https://doi.org/10.1016/j.jacr.2021.08.006
Expert Panel on Gastrointestinal Imaging, Laura R., Abhinav Vij, Atif Zaheer, Ihab R. Kamel, Kristin K. Porter, Hina Arif-Tiwari, Mustafa R. Bashir, et al. “ACR Appropriateness Criteria® Epigastric Pain.J Am Coll Radiol 18, no. 11S (November 2021): S330–39. https://doi.org/10.1016/j.jacr.2021.08.006.
Expert Panel on Gastrointestinal Imaging, Vij A, Zaheer A, Kamel IR, Porter KK, Arif-Tiwari H, et al. ACR Appropriateness Criteria® Epigastric Pain. J Am Coll Radiol. 2021 Nov;18(11S):S330–9.
Expert Panel on Gastrointestinal Imaging, Laura R., et al. “ACR Appropriateness Criteria® Epigastric Pain.J Am Coll Radiol, vol. 18, no. 11S, Nov. 2021, pp. S330–39. Pubmed, doi:10.1016/j.jacr.2021.08.006.
Expert Panel on Gastrointestinal Imaging, Vij A, Zaheer A, Kamel IR, Porter KK, Arif-Tiwari H, Bashir MR, Fung A, Goldstein A, Herr KD, Kamaya A, Kobi M, Landler MP, Russo GK, Thakrar KH, Turturro MA, Wahab SA, Wardrop RM, Wright CL, Yang X, Carucci LR. ACR Appropriateness Criteria® Epigastric Pain. J Am Coll Radiol. 2021 Nov;18(11S):S330–S339.
Journal cover image

Published In

J Am Coll Radiol

DOI

EISSN

1558-349X

Publication Date

November 2021

Volume

18

Issue

11S

Start / End Page

S330 / S339

Location

United States

Related Subject Headings

  • United States
  • Societies, Medical
  • Nuclear Medicine & Medical Imaging
  • Magnetic Resonance Imaging
  • Humans
  • Fluoroscopy
  • Evidence-Based Medicine
  • Abdominal Pain
  • 3202 Clinical sciences
  • 1117 Public Health and Health Services