A Cross Sectional Study to Evaluate the Sensitivity, Specificity and Predictive Value of Ultrasonography in Diagnosing Non Traumatic Acute Abdomen

Abstract

Background and objectives: ABSTRACT Acute abdomen designates symptoms and signs of intra abdominal disease. It usually account for 5-10% of all emergency admissions and requires a rapid, accurate diagnostic work up is required for the institution of appropriate management. This study aims at evaluating the sensitivity, specificity and predictive values of ultrasound in diagnosing non traumatic acute abdomen. . Methods: The present study was conducted in the Department of Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum on patients presenting with acute abdominal pain meeting the inclusion criteria during the period of January 2008 to December 2008. The ultrasound findings of 65 patients operated for acute abdominal symptoms were compared to histopathologcal or operative findings. The accuracy of ultrasound is assessed statistically by calculating positive predictive values and sensitivity of each of the abdominal conditions. Results: Ultrasound has a poor sensitivity ( 65% ) but a very high predictive value ( 92.85% ) in diagnosing acute appendicitis. Ultrasound provided corroborative evidence in case of bowel perforation ( sensitivity 85% ) and intestinal VIII obstruction. ( sensitivity 60% ) . It is fairly accurate in detecting biliary pathology with a sensitivity of 80% for acute cholecystitis. Ultrasonography has a combined sensitivity of 72.02% and a specificity of 66.7% in all the acute abdominal conditions. Conclusions: Ultrasound is a useful imaging modality in diagnosing acute abdominal conditions which need surgical attention. It continues to be a first line investigation to evaluate acute abdomen and can be considered as an extension of clinical examination.