A Comparative Evaluation of Various Imaging Findings with Per Operative Findings in Acute Abdomen
Journal Title: International Journal of Anatomy Radiology and Surgery - Year 2018, Vol 7, Issue 4
Abstract
Introduction: Abdominal pain, severe in nature, that requires immediate medical and or surgical care may be referred to as acute abdomen. In view of its morbidity and mortality, it becomes essential for a prompt and accurate diagnosis. Due to the non-specific nature of presentation the clinical diagnosis is often challenging. Imaging plays an important role in the treatment and management of these patients. Aim: To compare various imaging modalities and peroperative findings in acute abdomen with associated evaluation of sensitivity, specificity, positive and negative predictive values as well as accuracy of the same. Materials and Methods: This was time bound prospective study in which 50 patients referred to the Department of Radiodiagnosis with clinical history of acute abdomen were taken in a period of 18 months from December 2014 to August 2016. They underwent Plain Radiography, Ultrasonography and Computed Tomography Examination after eliciting adequate history. Later the imaging findings were correlated with the per-operative findings. Results were statistically analysed using SPSS version 18.0. Results: Out of the 32 males and 18 females of varying age groups the most common age of presentation was between 21 to 30 years. Acute appendicitis followed by intestinal perforation and obstruction were the most common cause for pain abdomen. Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and diagnostic accuracy in diagnosing hollow viscus perforation were 84.62%, 97.30%, 91.67%, 94.74% and 94% respectively for X-ray erect, were 76.92%, 97.30%, 90.91%,92.31% and 92% respectively for USG and 100% throughout for CT. Likewise, for diagnosing intestinal obstruction radiography was 100% throughout, while abdominal ultrasonography was 90%, 97.50%, 90%, 97.50% and 96% respectively, as compared to computed tomography which remained 100% throughout. In diagnosing appendicular pathology sonography was 91.30%, 96.20%, 95.45%, 92.86% and 94% respectively, as compared to computed tomography which remained 100% throughout. Imaging findings of acute abdomen were correlating well with per operative findings (98%). Conclusion: It was found that Plain radiograph of abdomen was useful in patients with hollow viscous perforations and intestinal obstruction. Sonography remained the primary technique of choice in acute abdomen especially in pediatric patients (two), thin young adults (eleven) and pregnant patients (one). Computed tomography was the most sensitive and specific investigation for pain abdomen.
Authors and Affiliations
Krishnappa Nasappa, Ajit Kumar Reddy, Siddappa Shirahatti
Keywords
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- EP ID EP534845
- DOI 10.7860/IJARS/2018/36311:2434
- Views 136
- Downloads 0
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