R Mohan Kumar, Anupam Jhobta, Sumala Kapila, Shruti Thakur, Sushma Makhaik, Neeti Aggarwal, Charu S Thakur 1. Junior Resident, Department of Radiodiagnosis, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India.
2. Professor, Department of Radiodiagnosis, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India.
3. Associate Professor, Department of Radiodiagnosis, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India.
4. Assistant Professor, Department of Radiodiagnosis, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India.
5. Professor, Department of Radiodiagnosis, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India.
6. Professor, Department of Radiodiagnosis, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India.
7. Assistant Professor, Department of Radiodiagnosis, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India.
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: Acute abdomen can sometimes be life-threatening and requires an exact diagnosis and appropriate management to avoid mortality among patients. Multi-detector Computed Tomography (MDCT) provides a specific diagnosis and the whole picture of pathology, especially in patients with inconclusive diagnoses.
Aim: To evaluate the accuracy of MDCT in diagnosing non-traumatic acute abdominal and pelvic emergencies.
Materials and Methods: A cross-sectional study was conducted on 100 patients who presented with acute abdomen and had inconclusive diagnoses based on clinical examination, laboratory investigations, and other imaging modalities. MDCT was performed with a specific protocol depending on the clinical diagnosis. The MDCT results were compared with intraoperative findings, clinical recovery, and Histopathological Examinations (HPE). Data was entered into a Microsoft Excel spreadsheet and analysed using Statistical Package for Social Sciences (SPSS) version 20.0.
Results: The MDCT diagnosis was concordant in 95% of patients and discordant in 5% of patients. Acute appendicitis was the most common cause of acute abdomen (20%). Overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of MDCT in diagnosing the aetiology of acute abdomen were 96.49% (CI 87.89% to 99.57%), 97.67% (CI 87.71% to 99.94%), 98.21% (CI 90.45% to 99.95%), 95.45% (CI 84.53% to 99.44%), and 97%, respectively.
Conclusion: Since the clinical findings overlap in patients with acute abdomen, making an accurate clinical diagnosis is challenging. In these cases, MDCT provides a diagnosis with high accuracy and specificity in a short duration of time; hence, MDCT should be performed in acute abdominal emergencies for appropriate patient management.
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