Acute abdominal pain is a common chief complaint in patients examined in the emergency department (ED) and can be related to a myriad of diagnoses. Of all patients who present to the ED, 4%–5% have acute abdominal pain. The causes of acute abdominal pain range from life-threatening to benign self-limiting disorders. Acute appendicitis, diverticulitis, cholecystitis, and bowel obstruction are common causes of acute abdominal pain. Other important but less frequent conditions that may cause acute abdominal pain include perforated viscous and bowel ischemia. A confident and accurate diagnosis can be made solely on the basis of medical history, physical examination, and laboratory test findings in only a small proportion of patients. The clinical manifestations of the various causes of acute abdominal pain usually are not straightforward.
Aim of the study:
To compare the efficacy of US and CT in diagnosis of acute abdomen.
Materials and methods: The present study was conducted in the Department of Radio-Diagnosis, Rajindra Hospital, Patiala. The ethical clearance for the study was approved from the ethical committee of the hospital. US was performed with Philips Envisor or GE Logiq α-200 with a 3.5mhz sector or curvilinear probes. CT scan was performed with Siemens- Somatom Emotion 6 slice third generation spiral CT. In our study, we consider 60 patients referred to Department of Radio-Diagnosis, Rajindra Hospital, Patiala with clinical suspicion of acute abdomen. All patients were subjected to ultrasound abdomen. Before doing CT, a detailed history was taken and a thorough clinical examination was performed and findings recorded.
Results: Age distribution in our series ranged from 3-83 years. Maximum number of patients were in 41-60 years age group (50.00%). Second highest incidence was in 21-40 years age group (20.00%) followed by 61-80 years age group (16.67%). There were 33 males and 27 females with M:F ratio 1.2:1. Mean age in our study was 45 years. Median was 47 and Mode was 50. 60 (Maximum number) patients presented with abdominal pain (100%). Second most common symptom was vomiting which was seen in 34 patients (56.67%) followed by non-passage of stools in6 patients (10.00%) and abdominal distension in 5 patients (8.33%). MDCT has accuracy of 100% in mesenteric ischaemia, malrotation of gut, GB perforation, Pancreatitis and pseudomembranous colitis. MDCT has accuracy of approximately 98% in diagnosing other mentioned conditions. USG has accuracy of 100% in diagnosing G.B perforation and small bowel obstruction. USG has less efficacy in diagnosing other acute abdominal conditions.
Conclusion: From our study, it can 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. CT may then be reserved for patients with non-diagnostic US results. At present, MDCT can be considered the primary imaging technique for patients with acute abdominal pain.