On Duty
The emergency queries surgeons and clinicians call about — what to look for, the pitfalls, and the one-line answer they need. Organized by domain.
Acute abdomen — CT
Appendicitis?CTUSRight lower quadrant pain; the surgeon is deciding whether to book the OR tonight.Diverticulitis — complicated?CTLeft lower quadrant pain and fever; the team is choosing between outpatient antibiotics, admission, IR drainage, or surgery.Bowel obstruction?CTDistension and vomiting; the surgeon is deciding between an NG tube with observation and an urgent laparotomy.Free air — where's the hole?CTPeritonitic abdomen or free air on the plain film; the surgeon wants the perforation localized before the incision.Mesenteric ischemia? (CTA)CTPain out of proportion to examination, often with AF or a low-flow state; every hour of delay costs bowel.Active GI bleed? (CTA)CTHematochezia or melena with falling hemoglobin; IR is asking whether there is a target to embolize.Ruptured AAA?CTHypotension, back or abdominal pain, known or newly found aneurysm — minutes matter.Obstructing stone?CTAcute flank pain on an unenhanced CT; urology wants to know whether this stone passes on its own — and whether the kidney is infected.Abscess — can IR drain it?CTA septic patient with a collection on CT; the team is asking whether interventional radiology can put a catheter in it.
Emergency ultrasound
Acute cholecystitis?USRight upper quadrant pain and fever; surgery is weighing early cholecystectomy against a cholecystostomy tube.Testicular torsion?USAcute scrotal pain; salvage declines sharply with time but remains possible after 24 hours — a positive call is a phone call, regardless of symptom duration.Ovarian torsion?USSudden severe pelvic pain, often with nausea; the ovary is salvaged by the surgeon's clock, not the radiologist's certainty.Ectopic pregnancy?USPositive pregnancy test with pain or bleeding; gynecology is choosing between follow-up, methotrexate, and surgery — with urgent operative assessment when instability and suspected hemoperitoneum coexist.DVT?USSwollen painful leg; the answer starts or withholds anticoagulation tonight.
Chest — CT
Pulmonary embolism? (CTPA)CTDyspnea, chest pain, or unexplained hypoxia; CTPA defines embolus distribution and contributes RV risk information, while treatment escalation depends on integrated clinical severity.Acute aortic syndrome? (CTA)CTTearing chest or back pain; type A goes to cardiac surgery within the hour, so the report leads with the Stanford type.Esophageal perforation?CTChest pain after vomiting, endoscopy, or a food-bolus impaction; delayed diagnosis worsens morbidity and mortality.