Role of Unenhanced CT scan of Non-Traumatic Acute Abdomen and its comparison with Ultrasonography
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 1
Abstract
Acute abdomen range from benign self-limiting to life threatening diseases. Sonography has become the ‘stethoscope for acute abdominal pain. Ultrasonography has simplicity, easy availability, portability, inexpensiveness, non-invasive nature, quickness and radiation free. The advent of helical computed tomography provided the combined advantages of speed and seamless coverage of the abdomen. The intraperitoneal or extra peritoneal fat that provided the most crucial information & would be infiltrated in acute abdominal disease. To Study the role & importance of plain CT scan in the initial assessment of non-traumatic acute abdomen and Comparison of this study with ultrasonography. The Study was conducted in our Department of Radio-diagnosis in 18 months. NCCT abdomen of 75 patients was performed after ultrasound screening of the abdomen. The maximum number of patients belongs to 18-28 years’ with male preponderance. The most common identifiable causes were acute appendicitis (20%), acute urinary colic (11%), acute pancreatitis (10%), acute cholecystitis (8%) & intestinal obstructions (8%) and indeterminate (21%). Sensitivity of Sonography was 60% for appendicitis, while sensitivity of NCCT was 87%. Acute pancreatitis was diagnosed in all cases by NCCT while Sonography could diagnose 42% only. Acute cholecystitis was diagnostic in all cases by USG, while NCCT was diagnostic in 67% cases thus USG is a significant modality for Acute Cholecystitis. NCCT for Ureteric Colic was diagnostic in all patients, while sonography was able to diagnose 63% only. Etiology of Acute intestinal obstruction can be diagnosed by NCCT. Overall accuracy, sensitivity, specificity for pneumoperitoneum (bowel perforation) was found to be 100%. Ultrasonography for Tubo-ovarian masses was diagnostic, while Hiatus hernia, Diverticulitis and gossypiboma were completely overpowered by NCCT over USG, which gave 100% positive predictive value of NCCT in diagnosing these cases We conclude that the Sonography is a very sensitive modality for Hepatobiliary, Renal, Gynecological emergencies. Nevertheless, since a sonographic examination may be unsatisfactory in a substantial proportion of instances, there should be no hesitation in resorting to an NCCT examination to demonstrate the precise cause of acute abdomen.
Authors and Affiliations
Kumud Julka, Pramod Sakhi, Vineet Kumar, Sheetal Singh, Amlendu Nagar, Rajat Agrawal, Durgesh Parmar
Keywords
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