Analysis of different pathologies presenting as acute abdomen and performance of MDCT in making the diagnosis with clinical, intra-operative and histopathology correlation

Abstract

Background: Acute abdomen is one of the most common emergencies presenting in the emergency room which requires immediate attention. Making an accurate diagnosis is of paramount importance in managing these patients, since most of these patients frequently require a surgical intervention. The divergence of patient population and the underlying pathology in acute abdomen calls for high quality imaging studies to make quick and precise diagnosis. Multi-detector computed tomography is an ideal tool in this regard. Materials and Methods: It is a prospective study conducted on 73 patients who presented with acute abdomen and subsequently underwent multi-detector computed tomography to ascertain the underlying pathology. The radiological findings in computed tomography were correlated with clinical, intra-operative and histopathological findings whenever available.Results: In our study the performance of multi-detector computed tomography, when compared with diagnosis made based on intra-operative findings, post-operative histopathology and clinical findings showed sensitivity of 97% and specificity of 75%. Overall Positive Predictive value of 98.5% and negative predictive value of 60% and accuracy of 96%.Conclusion: Since most of the patients presenting with acute abdomen have non-specific and overlapping clinical findings, making an accurate clinical diagnosis is challenging. In this scenario MDCT comes as a handy tool with high accuracy and good sensitivity and specificity. The results obtained in our study are comparable with other studies conducted worldwide.