Abstract
Aims And Objectives
- To compare MDCT findings with USG findings in patient with acute abdomen.
- To compare results of MDCT findings with operative findings / clinical outcome of patients.
Materials and Methods: Fifty patients with signs and symptoms suggestive of acute abdominal pain referred from various wards and outpatient departments were included in the study. Patients with acute abdominal pain were evaluated with both ultrasonography and computed tomography and the results were evaluated and compared.
Results: In our study Majority of cases were of pancreatitis, ureteric calculus and cholecystitis. USG diagnosis was consistent with Final diagnosis in 70% (35patients) of cases out of 50 patients. Diagnosis of MDCT was consistent with final diagnosis in 47patients with accuracy of MDCT in current study of 94%.USG findings were compared with MDCT findings and USG findings were in concordance with MDCT findings in 37 patients (74%). MDCT findings were compared with operative findings and 33 patients were operated out of 50 cases, among 33 operated cases, operative findings were similar in 28patients(84%). Pre CT diagnosis was compared with Post CT diagnosis and it was found that diagnosis was changed in 14 patients(28%) and diagnosis remained unchanged in 36cases (72%). Next Pre-CT management strategy was compared with actual Post-CT management strategy. In our study, after doing CT, management strategy was changed in 19patients (38%cases).
Conclusion: From our study, it could be concluded that MDCT is an effective imaging modality with results that have a positive effect on the management of many patients with acute abdominal pain. Radiation exposure is a drawback of MDCT but US may serve as an initial diagnostic test. CT may then be reserved for patients with non-diagnostic US results.
Keywords: acute abdomen, USG, CT.
References
- Tsushima Y, Yamada S, Aoki J, Motojima T, Endo K. Effect of contrast enhanced computed tomography on diagnosis and management of acute abdomen. Clinical Radiology. 2002; 57: 507-13.
- Stoker J, van Randen A, Lameris W, Boermeester MA. Imaging Patients with Acute Abdominal Pain. Radiology. 2009; 253:31-46.
- Walsh PF, Crawford D, Crossling FT, Sutherland GR, Negrette JJ, Shand J. The value of immediate ultrasound in acute abdominal conditions: a critical appraisal. Clin Radiol. 1990; 42:47-9.
- McGrath FP, Keeling F et al. The role of early sonography in the management of the acute abdomen. Clin Radiol. 1991; 44:172-4.
- Allemann F, Cassina P, Röthlin M, Largiadèr F. Ultrasound scans done by surgeons for patients with acute abdominal pain: a prospective study. Eur J Surg. 1999; 165:966-70.
- Nural MS, Ceyhan M, Baydin A, Genc S, Bayrak IK, Elmaili M. The role of ultrasonography in the diagnosis and management of non traumatic acute abdominal pain.Intern Emerg Med .2008;3 : 349-354.
- Pablo R. Ros, James E et al. ACR Appropriateness Criteria on Suspected Small-Bowel Obstruction. J Am Coll Radiol. 2006; 3:838-841 .
- Imran S . Accuracy of ultrasound in the diagnosis of upper abdominal pain. J Ayub Med Coll Abbottabad. 2003; 15:59-62 .
- Tsushima Y, Yamada S, Aoki J, Motojima T, Endo K. Effect of contrast-enhanced computed tomography on diagnosis and management of acute abdomen in adults. Clin Radiol. 2002; 57:507–13.
- MacKersie AB, Lane MJ, Gerhardt RT, Claypool HA, Keenan S, Katz DS, Tucker JE. Nontraumatic acute abdominal pain: unenhanced helical CT compared with three-view acute abdominal series. Radiology. 2005; 237:114-22
- J Sherck , Shatney C, Sensaki K, Selivanov V. The accuracy of computed tomography in the diagnosis of blunt small- bowel perforation.Am J Surg.1994;168(6):650-5.
- Maniatis V, Chryssikopoulos H, Roussakis A, Kalamara C , Kavadias S, Papadopoulos A et al. Perforation of the alimentary tract : evaluation with computed tomography. Abdom Imaging. 2000;25:373.
- Mamel J J. Use of endoscopy in peptic ulcer disease.Med ClinNorth Am. 1991;75(4):841-51.
- Yildirim D, Hut A, Tatar C, Donmez T , Akinci M, Toptas M. Prognostic factors in patients with acute mesenteric ischemia. Turk J Surg. 2017; 33(2): 104-109.
- Weir-McCall J, Shaw A, Arya A, Knight A, Howlett DC. The use of pre-operative computed tomography in the assessment of the acute abdomen. Ann R Coll Surg Engl. 2012; 94:102- 7.
- Hainaux B, Agneessens E, Bertinotti R, De Maertelaer V, Rubesova E, Capelluto E, et al. Accuracy of MDCT in predicting site of gastrointestinal tract perforation. AJR..2006; 187:1179-83.
- Foinant M, Lipiecka E, Buc E, Boire JY, Schmidt J, Garcier JM, Pezet D, Boyer L. Impact of computed tomography on patient's care in nontraumatic acute abdomen: 90 patients. J Radiol.2007; 88:559-66.
Corresponding Author
Dr Amit Mittal
Professor, Department of Radiodiagnosis and Imaging, M.M. Institute of Medical Sciences and Research, Mullana, Ambala, India
Ph: 8059931477, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v7i1.29
