Multidetector computerized tomography in acute abdomen
Keywords:Multidetector computerized tomography, Acute abdomen
Background: Acute abdominal pain is a common chief complaint in patients examined reporting to emergency department. The sensitivity of CT is 96% in acute abdomen. In order to decrease the mortality and morbidity rate, an efficient and correct diagnosis should be given for these patients. When investigations, like USG examinations are inconclusive, in such cases, multi-detector computer tomography is a widely accepted primary investigation of choice in patients coming with intense abdominal pain. The aim of the study was to evaluate the accuracy of MDCT in diagnosis of acute abdomen; document the sensitivity and specificity of MDCT; the incidence of different pathologies presenting as acute abdomen.
Methods: Prospective study on 64 subjects with acute pain abdomen was subjected to MDCT in GMC Srinagar. The duration of this study was from January to May 2019.
Results: About 36 patients were females and 28 were males. Youngest patient had an age of 7 years to eldest patient having age of 79 years. Most common causes of acute abdomen were acute pancreatitis in 21.8, acute appendicitis in 15.6% and bowel obstruction in12.5%. In our study the sensitivity, specificity and positive and negative predictable values of MDCT were 95.0%, 75%%, 98.3% and 60% respectively.
Conclusions: We conclude that MDCT has high sensitivity and accuracy rate. In inconclusive cases, MDCT is recommended to arrive at a definitive diagnosis. The results obtained in the study were comparable to pioneer studies conducted worldwide.
Powers JH. Acute appendicitis during the later decades of life: some remarks on the incidence of the disease in a rural area. Ann Surg. 1943;117:221–33.
MacKersie AB, Lane MJ, Gerhardt RT, Claypool HA, Keenan S, Katz DS, et al. Nontraumatic acute abdominal pain: unenhanced helical CT compared with the review acute abdominal series. Radiology. 2005;237:114–22.
Ahn SH, Mayo-Smith WW, Murphy BL, Reinert SE, Cronan JJ. Acute nontraumatic abdominal pain in adult patients: abdominal radiography compared with CT evaluation. Radiology. 2002;225:159–64.
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. The role of early sonography in the management of the acute abdomen. Clin Radiol. 1991;44:172–174.
Mun S, Ernst RD, Chen K, Oto A, Shah S, Mileski WJ. Rapid CT diagnosis of acute appendicitis with IV contrast material. Emerg Radiol. 2006;12:99–102.
Bolog N, Popiel A, Oancea I, Mangrau A, Beuran M, Nicolau E. Multidetector row spiral CT (MDCT) in bowel related non-traumatic abdominal emergencies. J Gastroenterol. 2003;12:319–24.
Frauenfelder T, Wildermuth S, Marincek B, Boehm T. Nontraumatic emergent abdominal vascular conditions: Advantages of multidetector row CT and three-dimensional imaging. Radiographics. 2004;24:481–96.
Sebastian L, Alkadhi H, Wildermuth S, Marincek B. Multidetector computed tomography of acute abdomen. Eur Radiol. 2005;15(12):2435–47.
Beger HG, Maier W, Blaock S, Buchler M. Imaging of the complications of Acute Pancreatitis? In: Malfertheiner P, Ditschuneit H, eds. Diagnostic procedures in pancreatic disease. Berlin: Springer – Verlag, 1986: 54-60.
Rao PM, Rhea JT, Novelline RA. Sensitivity and specificity of the individual CT signs of appendicitis: experience with 200 helical appendiceal CT examinations. J Comput Assist Tomogr. 1997; 21:686 -692.
Mangini M, Carrafiello G, Lagana D, Palma L, Novario R, Dionigi G, et al. Non-traumatic acute bowel disease: differential diagnosis with 64-row MDCT, Emerg Radiol. 2008;15:171–8.