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When your abdomen hurts – clarity through imaging.
Abdominal pain is an umbrella term for very different causes – from irritation through inflammation and stone disease to a space-occupying lesion. If the symptoms persist, recur or change, imaging provides certainty: ultrasound, MRI and – if necessary – CT make the abdominal organs visible and clarify what lies behind them. Worth knowing: the heart, too, can present as pain in the upper abdomen. Everything in one place, evaluated by experienced specialists.
Important: Sudden, severe chest pain – especially with shortness of breath, cold sweat or pain radiating into the arm, neck or upper abdomen – can be a heart attack. Please call the emergency services on 112 immediately.
A gastrointestinal infection or an irritation – for instance during periods of stress or after viral infections – often subsides on its own. If it does not, or if the symptoms recur or change, we clarify the cause: from inflammation through stone disease to a space-occupying lesion.
The gallbladder, pancreas and kidneys can also cause symptoms – through inflammation (such as cholecystitis, pancreatitis or pyelonephritis) or stone disease. Ultrasound and MRI (with MRCP) reliably depict such causes.
With abdominal pain, one should not pretend that nothing serious could ever be behind it. Of course it may also become necessary to rule out a tumour – in a targeted way and without drama (see below, “Disease facts & context”).
Upper abdominal pain, nausea or a feeling of pressure can come from the stomach – but sometimes also from the heart, for instance in an inferior wall infarction. That is why, with a corresponding risk profile, we take the heart into account as well.
Which examination makes sense depends on your symptoms. We choose in a targeted way – from radiation-free ultrasound through abdominal MRI to CT when it needs to be fast and comprehensive.
Radiation-free and immediately available: ultrasound assesses the liver, gallbladder, kidneys, spleen and free fluid – often the first step.
Without radiation and with high soft-tissue contrast: MRI depicts the liver, bile ducts (MRCP), pancreas and bowel wall in fine detail. Particularly for liver lesions and pancreatic cysts, guidelines name it the most accurate method for assessment and follow-up.¹ ²
If MRI does not provide a conclusive answer, or if there are persistent, suspicious clinical findings, a CT of the abdomen must be performed in individual cases. It images all abdominal organs within seconds and is often the decisive examination in acute or unclear situations.
For upper abdominal complaints with a risk profile, we include a cardiac cause in our assessment – because ultrasound and exercise ECG alone do not see the coronary arteries.
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Persistent, recurring or changing abdominal complaints should be investigated – also in order to rule out a tumour. The following figures put into perspective the order of magnitude involved: taken together, the most important malignant tumour diseases – from the abdominal organs and the urinary tract to the breast and female pelvic organs – cause considerably fewer deaths in Germany each year than coronary artery disease and its sequelae.³ ⁴
| Disease | Deaths/year (Germany, RKI)³ |
|---|---|
| Colorectal cancer | 22.670 |
| Pancreatic cancer | 19.416 |
| Liver cancer | 8.457 |
| Stomach cancer | 7.808 |
| Oesophageal cancer | 5.884 |
| Breast cancer | 18.713 |
| Ovarian cancer | 5.096 |
| Uterine (endometrial) cancer | 2.734 |
| Bladder cancer | 6.078 |
| Kidney cancer | 4.942 |
| Total of these tumour diseases | 101.798 |
| For comparison: CAD and its sequelae (heart failure, arrhythmias) | ~ 200.000 |
CAD-associated heart diseases – including heart failure and cardiac arrhythmias – cause more deaths than all of the tumour diseases listed above combined, and many times more than any single one of these tumour types; CAD is the most common cause of death in Germany overall.⁴ And it is precisely these heart diseases that can be assessed only to a limited extent with ultrasound and exercise ECG alone – the coronary arteries remain invisible. Anyone seeking certainty with a risk profile should therefore also take the heart into account.⁵ Because cardiology is located in the same building, this assessment can follow directly – without changing doctors and without travelling to another part of the city.