Evaluation of Acute Abdomen by Multidetector Computed Tomography: A Prospective Study in a Tertiary Care Hospital in Andhra Pradesh, India

Abstract

Abstract Background and Objective: Evidence on the efficiency of multidetector computed tomography (MDCT) in diagnosing acute abdomen in the Indian setting is lacking. This study was conducted to estimate the incidence of various causes of acute abdomen, correlate MDCT observations with postoperative findings, and estimate the sensitivity and specificity of MDCT findings. Methods: In this prospective study, 54 patients with acute abdomen were recruited in the emergency department (ED) of a tertiary care hospital in Chittoor, India. In these patients, MDCT observations were compared with postoperative findings, and the sensitivity and specificity of MDCT findings were estimated. Results: The majority of the patients presented with pain in epigastrium (n = 13, 24.1%), and 46 (85.2%) had nontraumatic acute abdomen. Pancreatitis was the major cause of nontraumatic acute abdomen. MDCT had failed to detect one case of acute appendicitis, one calculous cholecystitis, Meckel’s diverticulum, stricture ureter, and degloving injury of the colon. Overall, MDCT was positive for 57 out of a total of 63 conditions (eight patients had two different diagnoses) and it could rule out acute abdomen accurately in one patient. The sensitivity of MDCT in diagnosing acute abdomen was 92% and specificity was 100%. Conclusion: MDCT is a valuable diagnostic radiological investigation for patients with acute abdomen presenting to the EDs. Its multiple advantages put it ahead of the other traditional radiological investigations.