Role of X Ray and USG in Patient Admitted with Acute Abdomen (original) (raw)
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USG and CT correlation of non-traumatic acute abdomen
Back ground: Of all patients presenting to the Emergency Department(ED), approximately 10% have complaints of acute abdominal pain. Non-traumatic acute abdominal pain is one of the most common symptoms in adults presenting to the emergency department. Clinical assessment is sufficient to decide on the level of urgency, but not on the specific cause of the acute abdominal pain. The causes of abdominal pain vary from life threatening to the self-limiting. Management decision on the basis of clinical and laboratory tests alone can result in unnecessary intervention or delayed management. Hence a diagnostic modality has to be formulated which aids in clinical diagnosis and prevents mortalities. CT scan and ultrasound now become principal investigation in non-traumatic acute abdomen. This study aims to correlate the usefulness of USG abdomen and CT abdomen in patients presenting with acute abdominal pain in emergency department. Materials and Methods: The present study of computed tomography and ultrasound evaluation of non-traumatic acute abdomen was a prospective study of 100 patients using ultra sound and CT scan modality. The present study is carried out at department of radiology, Guru Gobind Singh Hospital and M P Shah Medical College, Jamnagar. The study was carried out between 2017 to 2019. Results were checked by two radiologists (PI and CO-PI) and final comparative data wasprepared from Computed Tomography (CT) and Ultrasound study. Results: Out of 100 patients in this study, 65 % were male and 35% were female. Youngest patient was 11nonth-old female baby and oldest patient was 100-year-old female, majority of the patients were adults with highest number of them in the age group of 30-40 years (20 %), among our patients 100 patients (29%) showed changes of pancreatitis (13 %) showed appendicitis and small bowel obstruction other common conditions encountered were cholecystitis (13 %) and renal ureteric calculi (8%), USG abdomen was abnormal in 55.17% of the pancreatitis and 76% of patients with appendicitis and small bowel obstruction and 81% in patients with cholecystitis and 87% in patients with renal or ureteric calculi. Conclusion: In the present series of study conducted for correlation of CECT abdomen and USG abdomen in the evaluation of acute non-traumatic abdomen, CECT abdomen was more sensitive and accurate in diagnosing the causes of non-traumatic acute abdomen, although USG abdomen was proved to be valuable first hand tool in management of non-traumatic acute abdomen.
The role of US examination in the management of acute abdomen
Critical Ultrasound Journal, 2013
Acute abdomen is a medical emergency, in which there is sudden and severe pain in abdomen of recent onset with accompanying signs and symptoms that focus on an abdominal involvement. It can represent a wide spectrum of conditions, ranging from a benign and self-limiting disease to a surgical emergency. Nevertheless, only one quarter of patients who have previously been classified with an acute abdomen actually receive surgical treatment, so the clinical dilemma is if the patients need surgical treatment or not and, furthermore, in which cases the surgical option needs to be urgently adopted. Due to this reason a thorough and logical approach to the diagnosis of abdominal pain is necessary. Some Authors assert that the location of pain is a useful starting point and will guide a further evaluation. However some causes are more frequent in the paediatric population (like appendicitis or adenomesenteritis) or are strictly related to the gender (i.e. gynaechologic causes). It is also important to consider special populations such as the elderly or oncologic patients, who may present with atypical symptoms of a disease. These considerations also reflect a different diagnostic approach. Today, surely the integrated imaging, and in particular the use of multidetector Computed Tomography (MDCT) has revolutionised the clinical approach to this condition, simplyfing the diagnosis but burdening the radiologists with the problems related to the clinical management. However although CT emerging as a modality of choice for evaluation of the acute abdomen, ultrasonography (US) remains the primary imaging technique in the majority of cases, especially in young and female patients, when the limitation of the radiation exposure should be mandatory, limiting the use of CT in cases of nondiagnostic US and in all cases where there is a discrepancy between the clinical symptoms and negative imaging at US.
Comparative Analysis of Clinical, Radiological and Operative Findings in Acute Abdomen
2015
A prospective observational study was conducted on 125 patients with acute abdomen to compare clinical, radiological and operative finding. The most common age group was 21-30 years with male preponderance. Nausea or Vomiting were most predominant symptoms in these patients. Anorexia followed by fever was the next important symptom. Guarding was the single statistically significant sign (p=.02), other common signs were tenderness, rigidity, distention, tachycardia and silent abdomen. A total of 59(47.2%) patients had raised total leucocyte count with sensitivity of 47.54%, and specificity of 66.67% respectively (p = .58); differential leukocyte count was raised in 86(68.8%) patients with sensitivity of 70.49% and positive predictive value of 97.73% the test was statistically significant (p = .0092). Appendicitis was the most common cause of laparotomy followed by perforation peritonitis, obstruction and mesenteric ischemia. Diagnostic accuracy of X-ray was 72.86% while that of US wa...
Management of acute abdomen : Study of 110 cases
2016
Background: The term acute abdomen designates symptoms and signs of intraabdominal diseases usually treated best by surgical operation. Many diseases, some of which do not require surgical treatment, produce abdominal pain, so the evaluation of patients with abdominal pain must be methodical and careful. The proper management of patients with acute abdominal pain requires a timely decision about the need for surgical operation. The term “acute abdomen” should never be equated with the invariable need for operation. The abdomen has been referred to as Pandora’s magic box. Very often an accurate diagnosis cannot be made without surgery and many wonders are revealed on opening the abdomen. So it is often the last court of appeal in investigating abdominal cases. The general rule can be laid down that the majority of severe abdominal pains that ensue in patients who have been previously well, and that last as long as six hours, are caused by conditions of surgical import. Materials and ...
Clinical study, diagnostic aids and management of acute abdomen
International Journal of Current Research in Biology and Medicine
Background: Evaluation of the emergency department(ED) patient with acute abdomen is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. The term acute abdomen is constantly applied to such cases that signify the urgent need for prompt diagnosis and active treatment. Objective: This study is designed to examine the present state of diagnosis and management of acute abdomen and to develop evidence based guidelines for the diagnostic pathway and management of acute abdomen. Result: Our study showed that acute cholecystitis was the most common cause (29%) in patients presenting with acute abdomen followed by perforation peritonitis (25%). Pain and vomiting (49%) was the most common complaint followed by distension (44%). Ultrasound is the most sensitive and most commonly used diagnostic aid in acute abdomen. Majority of patients(73%) required surgical intervention. Conclusion: Abdominal pain is a common presenting complaint in the ED and clinicians must consider multiple diagnoses, especially in those cases that require immediate intervention in order to limit morbidity and mortality.
A comparative study of pre-operative with operative diagnosis in acute abdomen
Kathmandu University medical journal (KUMJ)
In this observational study (from August 2000 to January 2001) 102 patients of all age group with non-traumatic acute abdomen were studied to see the negative laparotomy rate and the diagnostic accuracy and predictive values of different investigations in acute abdomen. The disease was most common in the age group 20-29 years with male predominance. More than half of the acute abdomen was due to the acute appendicitis. Neutrophil leucocyte count had the highest sensitivity (91.5%) while Plain X-ray abdomen showed the highest specificity (88.8%) and positive predictive value (88.6%) in diagnosing acute abdomen. Urinalysis showed the highest negative predictive value (93.3%). Overall diagnostic accuracy was 78.4%, which was statistically significant (p<0.05). Diagnostic accuracy was highest in bowel obstruction (82.4%) and lowest in peritonitis due to viscus perforation (69.0%). Negative laparotomy rate was 17.6% in the study, which was statistically significant (p<0.05). It was...
International Journal of Research in Medical Sciences, 2016
Background: Acute abdomen is a loose term frequently used to describe the acute abdominal pain in a subgroup of patients who are seriously ill developing suddenly, over a period of several hours or few days.Methods: It was a prospective comparative study between abdominal plain radiography and ultrasonography in non-traumatic acute abdominal emergencies in Tertiary Care Hospital.Results: All the included patients (140) were imaged with abdominal X-rays series (AAS) and Ultrasonography (US) by different blinded radiologists without conveying results to either. Final diagnosis was made on the basis of clinical findings / laboratory or biochemical findings /radiological evaluation /therapeutic response / operative findings / histopathological examination. The entire data was collected, recorded and statistically analyzed as per objectives. GIT system was most commonly involved, in 75/140 cases (53.57%). Most common diagnoses were acute appendicitis, KUB calculus disease and acute chole...
Study of role of laparoscopy in acute abdomen
International Journal of Biomedical Research, 2015
Study regarding role of laparoscopy in acute abdomen was conducted at Shree Chhatrapati Shivaji Maharaj Sarvopachar Rugnalaya, Solapur during the period from May 2004 to November 2006. Patients of both sex and all age groups were included in the study. A total 30 patients were studied and results were as tabulated and analysed. In this study, total laparoscopic management was possible in 23 cases (76.7%) while laparoscopy assisted surgery were done in 4 cases (13.3%). In this study, 5 cases presented as adhesive small bowel obstruction, 1 with inflamed Meckels diverticulum and 1 as case of ileoileal intussusception. All these findings were missed on radiological investigations, but werediagnosed accurately on laparoscopy. Laparoscopic treatment was done in 9 cases presented as acute abdomen due to intestinal obstruction. This incidence is equal to that of acute cholecystitis. Of these, 5 patients (55.6%) were due to post operative adhesions. We conclude that laparoscopy is valuable, safe feasible and accurate alternative for management of patients of acute abdomen. It is very useful for final diagnosis of patients of acute abdomen. Even negative laparotomies can be avoided using laparoscopy. Therapeutic laparoscopy can be accomplished in majority of patients of acute abdomen.
Observation and Management of Cases of Acute Abdomen Admitted In Dmch Emergency
IOSR Journals , 2019
Introduction: Acute abdomen is all time enigma, rightly described as Pandora's box by Desai and Irani 1. It is an Intra-abdominal condition of abrupt onset usually associated with pain due to Inflammation, perforation, obstruction, infarction or rupture of abdominal organs requiring emergency surgical or medical intervention. Aim: To study the clinical observation and management of cases of acute abdomen patients admitted in the surgical emergency department DMCH Darbhanga.(2011-2013). A total number of hundred cases(new born to 70 years of age,58 males,42 females) of acute abdomen were included in this study. Proper work up of the admitted patients were done and diagnosis was made on basis of clinical examination ,,routine investigations, and radiological investigations.Patients were then managed either surgically or conservatively according to need. Results: Intestinal obstruction due to various pathologiesis the leading cause of acuteabdomen followed by perforations, followed by inflammation of viscus. Most common manifestation of acute abdomen is pain. majority of patients belong to low socio economic status. Males dominates over females. Age wise incidence is highest in 3 rd and 5 th decade of life .77% of 100 cases were treated with open surgery and 9% with laparoscopic surgery and 16% treated conservatively.
Clinical Evaluation and Role of Usg in Patients of Acute Appendicitis in a Rural Hospital
Journal of Evolution of medical and Dental Sciences, 2014
INTRODUCTION: Acute appendicitis is the commonest emergency met in surgical practice. The clinical features sometimes being non-specific and list of differential diagnosis is too long. Diagnosis being particularly difficult in females due to associated gynaecological and obstetric conditions. The aim is to reduce unnecessary laparotomies and incidence of appendiceal perforation which is associated with significant post-operative morbidity. Reported approaches to achieve this objective include emergency laparotomy, Ultrasonography (USG), scoring system, CT scan etc. In peripheral areas USG remains most widely available and preliminary investigative for establishing definitive diagnosis in addition to clinical suspicion. AIM: Clinical evaluation and role of ultrasonography in patients of acute appendicitis in a rural hospital. OBJECTIVES: To study clinical profile of acute appendicitis. Role of USG in diagnosis of acute appendicitis. METHODS: 50 patients of acute abdomen suspected to ...