Computed tomography versus ultrasonography in the evaluation of periumbilical abdominal pain

Abstract

Background: The objective of this study was to study, assess, and make early diagnosis of periumbilical pain abdomen accurately. Aims and Objectives: To study, assess, and diagnose causes of periumbilical abdominal pain accurately so as to minimize the unnecessary exploratory laparotomy and operations and consequently improved patient care and to compare the role of ultrasonography (USG) and computed tomography (CT) in the evaluation of various causes of periumbilical abdominal pain. Materials and Methods: This prospective study (CTRI/2023/01/048809) was done on 315 patients with periumbilical pain at M.L.B. Medical College Jhansi, Uttar Pradesh on PHILIPS 16 Slice multi-detector CT SCAN machine and GE Vivid T8 ultrasound machine. These patients were blindly and randomly divided by chit system into two groups irrespective of their age and gender. The first group of patients which included 160 patients undergoes ultrasonographic evaluation and the other group of patients which includes 155 patients undergoes contrast-enhanced computed tomographic evaluation. Results: Among 315 patients, the most common cause of periumbilical pain was found to be appendicitis followed by bowel pathologies which include gastrointestinal tuberculosis. Conclusion: USG is the initial modality and modality of choice in female and young (3rd and 4thdecade) patients presenting with periumbilical pain as it is diagnostic in gynecological causes of periumbilical pain and also minimizes unnecessary radiation exposure to female and young patients. Contrast-enhanced CT is the modality of choice in male and old age patients (5th and 6th decade) as it is diagnostic in vascular causes. Overall plain CT has limited role.