A 27-year-old G4P2 female at 25-weeks gestation presents to the emergency department with right upper quadrant abdominal pain. The pain began yesterday and was initially a generalized discomfort that localized to the right upper quadrant. She has associated nausea without vomiting and has had minimal appetite for the last day. Her vital signs on arrival to the emergency department are T 38.2 C, HR 125 bpm, RR 22, BP 110/70. Abdominal examination reveals localized right upper quadrant tenderness with voluntary guarding but no peritonitis.

Abdominal pain is a common complaint in pregnancy and abdominal pathology in pregnant patients may arise from both obstetric and non-obstetric causes.

Delayed diagnosis of common conditions in pregnant patients results in significant morbidity in this high-risk group compared to their peers.

The tenets of diagnosis and management are the same in pregnant and non-pregnant patients.

CT is still extremely useful as a diagnostic modality in pregnancy and should not be withheld from pregnant patients if indicated. A conversation with the patient regarding the limited associated risk of radiation should be undertaken and shared decision making regarding how to proceed should be discussed.

An understanding of the anatomic and physiologic changes associated with pregnancy and how they affect patient presentation is paramount to timely diagnosis and management in these patients. A multi-disciplinary team-based approach to these patients can help in the diagnosis and ideal treatment of this vulnerable patient population.

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