Role of traditional abdominal radiography in patients with nontraumatic acute abdominal pain in the era of computed tomography

Dr. Nipun Gupta; Dr. Shivali Kashikar

Volume : VI, Issue : IX, September - 2017

Role of traditional abdominal radiography in patients with nontraumatic acute abdominal pain in the era of computed tomography

Dr. Nipun Gupta, Dr. Shivali Kashikar

Abstract :

Aim: To assess comparative role of traditional abdominal radiography and computed tomography in patients with non–traumatic acute abdominal pain.

Background: Acute abdomen is a clinical entity which is characterized by acute abdominal pain of sudden onset. Patients with an acute abdomen constitute the largest group of patients presenting to the emergency department. It is crucial to identify the patients requiring surgery for the timely management. Plain radiographs are still an important initial investigation in the evaluation of patients with acute abdomen. The introduction of multidetector CT (MDCT) has impacted imaging of all organs of the body, especially the abdomen.

Materials and Methods: After informed consent of patients, 167 patients are included in the study. These patients underwent an erect abdominal radiography and a MDCT CT examination. Final diagnosis was established with surgical, biochemical and clinical follow up.

Result: Among the 167 patients examined, CT yielded an overall sensitivity, specificity, and accuracy of 93.0%, 92.1%, and 93.6%, respectively. The abdominal radiography interpretations yielded an overall sensitivity, specificity, and accuracy of 34.0%, 83.8%, and 52.0%, respectively. The accuracy of CT was significantly greater than the accuracy of plain abdominal radiography.

CONCLUSION: Abdominal radiography is an insensitive technique in the evaluation of patients with nontraumatic acute abdominal pain but can be used in initial evaluation in patients with suspected renal calculus, obstruction and perforation. CT is a more sensitive and accurate technique in the evaluation of patients with nontraumatic acute abdominal pain and provides more information than abdominal radiography. Guidelines and protocols should be established to minimise the indiscriminate use of low diagnostic yield modalities like abdominal radiography and conserve time and cost by using the better modalities as this can have impact on management and outcome.