Role of Ultrasound Scan in Non-Traumatic Acute Abdomen Presenting in Surgery Department of a Tertiary Care Center

  • Sumnima Acharya Lumbini Medical College and Teaching Hospital https://orcid.org/0000-0001-8612-671X
  • Awadhesh Tiwari Lumbini Medical College and Teaching Hospital
  • Rupesh Sharma Lumbini Medical College and Teaching Hospital https://orcid.org/0000-0002-3422-6150
  • Santosh Paudel Lumbini Medical College and Teaching Hospital
Keywords: Acute abdomen, Sensitivity, Specificity, Ultrasonography

Abstract

Introduction: An acute abdomen is defined as a clinical condition characterized by severe abdominal pain developing suddenly over several hours or less. Ultrasonography (USG) helps the managing surgeons arrive at early diagnosis and rule out alternative diseases, thus reducing negative laparotomy rate. This study analyzed the diagnostic yield of USG in patients with non-traumatic acute abdomen presenting to Surgery department via Emergency department/outpatient department of a tertiary hospital. Methods: This cross-sectional observational study included 110 patients with non-traumatic acute abdominal pain who were sent for USG examination. The percentage concordance of USG diagnosis with the final diagnosis at discharge was determined in terms of sensitivity, specificity, positive and negative predictive values for acute abdomen. Results: Of 110 patients, correct clinical diagnosis was made in 83 patients (75%) while USG made a correct diagnosis in 101 patients (91%). Hence, with the help of USG, accuracy of diagnosing cause of acute abdomen increased by 16 %. The sensitivity and specificity of USG in diagnosis of acute appendicitis were 87.7% and 98.3% respectively. Conclusion: USG is easily available and non-invasive modality without radiation exposure and requiring minimal patient preparation. USG should, therefore, be an important routine diagnostic investigation in patients presenting with acute abdomen.

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Author Biographies

Sumnima Acharya, Lumbini Medical College and Teaching Hospital

Assistant Professor,

Department of Radiodiagnosis.

Awadhesh Tiwari, Lumbini Medical College and Teaching Hospital

Associate Professor and Head,

Department of Radiodiagnosis.

Rupesh Sharma, Lumbini Medical College and Teaching Hospital

Assistant Professor,

Department of Radiodiagnosis.

Santosh Paudel, Lumbini Medical College and Teaching Hospital

Resident,

Department of Surgery.

References

Diethelem AG. The acute abdomen. In: Sabiston DC jr. (ed.) Sabiston Textbook of surgery. Philadelphia: Saunders;1986. p.790-809.

Stoker J, Randen AV, Lameris W, Boermeester MA. Imaging patients with acute abdominal pain. Radiology. 2009;253(1):31-46. PMID: 19789254. DOI: https://doi.org/10.1148/radiol.2531090302

Cope ZS, Silen W. Cope’s early diagnosis of the acute abdomen. 18thed. New York Oxford Oxford University Press;1991. Available from: https://www.worldcat.org/title/copes-early-diagnosis-of-the-acuteabdomen/ oclc/1110787349?referer=null&ht=edition

Puylaert JB, Rutgers PH, Lalisang RI, de Vries VC, Van der Werf SD, Dorr JP, et al. A prospective study of ultrasonography in the diagnosis of appendicitis. N Engl J Med. 1987;317(11):666– 9. PMID: 3306375. DOI: https://doi.org/10.1056/NEJM198709103171103

Prasad H, Rodrigues G, Shenoy R. Role of ultrasonography in nontraumatic acute abdomen. The Internet Journal of Radiology. 2007;5(2):1-2. Available from: http://eprints.manipal.edu/id/eprint/142824

Allemann F, Cassina P, Rothlin M, Largiader F. Ultrasound scans done by surgeons for patients with acute abdominal pain: a prospective study. Eur J Surg. 1999;165(10):966– 70. PMID: 10574106. DOI:https://doi.org/10.1080/110241599750008099

KC S, De A, Pathak M, Sathian B. Diagnostic Role of Ultrasonography in Acute Appendicitis: A Study at a Tertiary Care Hospital. American Journal of Public Health Research. 2015;3(5A):23–8. Available from: http://pubs.sciepub.com/ajphr/3/5A/6/ajphr-3-5A-6.pdf

Tauro LF, Premananda TS, Aithala PS, George C, Suresh HB, Acharya D. Ultrasonography is still a useful diagnostic tool in acute appendicitis. Journal of Clinical and Diagnostic Research. 2009;3(5):1731-36. Available from: https:// www.jcdr.net/articles/PDF/567/475.pdf

Garba ES, Chom ND. Ultrasound in the diagnosis of appendicitis: A plea for caution. Niger Journal of Surgical Research. 2006;8(3-4):132–4. DOI: http://dx.doi.org/10.4314/njsr.v8i3-4.54874

Puylaert JB. Ultrasonography of the acute abdomen: gastrointestinal conditions. Radiol Clin North Am. 2003;41(6):1227–42. PMID: 14661668. DOI: https://doi.org/10.1016/s0033-8389(03)00120-9

Pinto A, Reginelli A, Cagini L, Coppolino F, Stabile Ianora AA, Bracale R, et al. Accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis: review of the literature. Crit Ultrasound J. 2013;5(Suppl 1):S11. PMID: 23902680. DOI: https://doi.org/10.1186/2036-7902-5-S1-S11

Shea JA, Berlin JA, Escarce JJ, Clarke JR, Kinosian BP, Cabana MD, et al. Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease. Arch Intern Med. 1994;154(22):2573–81. PMID: 7979854

Pandey L, Milicevic M, Grbic R, Bulajic M, Krstic R, Golubovic G, et al. The value of ultrasound in staging the severity of acute pancreatitis. Acta ChirIugosl. 1997-1998;44– 45(1–1):63–7. PMID: 10951817

Galarraga D, Garcia N, Barrios S, Hinestrosa H, Quiroz E. Acute pancreatitis: the value of ultrasonography in its prognosis. G E N. 1992;46(2):93–101. PMID: 1340822

Ashaolu BA, Asaleye MC, Adetiloye AV, Alatise IO. Spectrum of disease and diagnostic value of ultrasound in adult patients with non traumatic acute abdomen in a Nigerian tertiary health facility. Niger J Surg. 2015;21(1):6- 12. PMID: 25838758. DOI: https://dx.doi.org/10.4103%2F1117-6806.152731

Hefny AF, Abu-Zidan FM. Sonographic diagnosis of intraperitoneal free air. Journal of Emergencies Trauma, and Shock. 2011;4(4):511– 3. Available from: http://www.onlinejets.org/text.asp?2011/4/4/511/86649

Chadha D, Kedar RP, Malde HM. Sonographic detection of pneumoperitoneum: an experimental and clinical study. Australas Radiol. 1993;37(2):182–5. PMID: 8512509. DOI: https://doi.org/10.1111/j.1440-673.1993.tb00046.x

Published
2019-12-29
How to Cite
1.
Acharya S, Tiwari A, Sharma R, Paudel S. Role of Ultrasound Scan in Non-Traumatic Acute Abdomen Presenting in Surgery Department of a Tertiary Care Center. J Lumbini Med Coll [Internet]. 29Dec.2019 [cited 8Jul.2020];7(2):56-0. Available from: https://jlmc.edu.np/index.php/JLMC/article/view/293
Section
Original Research Article