Publication:

Study on the efficiency of computed tomogram and ultrasonogram in the diagnosis of intra-abdominal injuries following trauma

Background Blunt abdominal trauma (BAT) can be a big diagnostic dilemma even to the most experienced surgeon. Clinical signs along with imaging studies such as ultrasonogram (USG) and CT scan play a major role in decision making. A descriptive study was conducted to find out which imaging modality is most beneficial in evaluating BAT.

Methods Fifty patients with BAT (age ranges from 15 to 65 years) who had undergone imaging studies as well as laprotomy were included in the study. A thorough history was taken from the volunteers. Patients who presented with unstable vitals necessitating emergency surgery without imaging studies and those patients who were managed conservatively were excluded from the study.

Results Results showed that 64% of BAT was due to road traffic accident (RTA). Age group 20-29 and male sex were the vulnerable groups for RTA. However, no statistically significant difference found between the age groups and etiology of BAT (p = 0.204). Spleen was the most common organ injured, followed by liver and small bowel. Ultrasonogram (USG) could pick up 50% of free fluid with a positive predictive value (PPV) of 96%. But, it could pick up only 9.4% cases of multiple organ injury with PPV of 100%. Sensitivity of computed tomogram (CT) scan in identifying splenic injury was 92.3% with PPV of 70.6%. Sensitivity of CT scan in identifying multiple organ injury was 71.9 % with PPV of 95.8%.

Conclusions Sensitivity of CT scan in identifying multiple organ injury is higher than that of USG. The result concluded that clinical suspicion along with appropriate imaging studies and watchful observation will help a surgeon in diagnosing even the most complicated BAT cases.