Analysis of Breaking News Content
Introduction
The study aimed to determine the range of diseases causing acute surgical abdomen using ultrasonography and to compare ultrasound diagnoses with surgical diagnoses in a low-income resource setting. This comparison is crucial for understanding the effectiveness of ultrasound as a diagnostic tool in resource-limited environments.
Materials and Methods
A prospective observational study was conducted on patients presenting with acute abdomen for abdominal ultrasonography. The ultrasound diagnoses were compared with surgical diagnoses. Statistical methods used included Chi-square and Fisher’s exact tests for association, and Kappa statistics for interobserver agreement. Key diagnostic performance markers included sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy.
Results
The most common conditions identified were appendicitis (27.5%), bowel perforation (21.7%), and ectopic pregnancy (12.5%). Ultrasonography demonstrated high diagnostic performance with an overall sensitivity of 80.8%, specificity of 99.1%, PPV of 89.0%, NPV of 98.3%, and diagnostic accuracy of 97.6%. Specific sensitivities and specificities were:
- Acute appendicitis: 69.7% sensitivity, 98.9% specificity
- Bowel perforation: 88.5% sensitivity, 96.8% specificity
- Ectopic pregnancy: 100% sensitivity, 100% specificity
There was a significant relationship between ultrasound and surgical diagnoses for most conditions (P < 0.001), except for appendiceal abscess (P = 0.05). Interobserver agreement was beyond chance (0.20 < κ ≤ 1.00).
Conclusion
The study concludes that with skilled personnel, there is a high concordance between ultrasound and surgical diagnoses of acute abdomen. Therefore, ultrasonography should be a part of the initial evaluation for patients with surgical acute abdomen in settings where emergency abdominal computed tomography (CT) is not readily available, accessible, or affordable.
Summary
Introduction
The study’s objective was to determine the spectrum of acute surgical abdomen pathologies using ultrasound and compare these diagnoses with surgical diagnoses in a low-income resource setting.
Materials and Methods
A prospective observational study was conducted with consecutive patients presenting with acute abdomen for abdominal ultrasonography. Statistical tests included Chi-square and Fisher’s exact tests for correlation, and Kappa statistics for interobserver agreement. Diagnostic performance markers included sensitivity, specificity, PPV, NPV, and diagnostic accuracy.
Results
The most common conditions were appendicitis (27.5%), bowel perforation (21.7%), and ectopic pregnancy (12.5%). Ultrasonography showed high diagnostic performance with overall sensitivity of 80.8%, specificity of 99.1%, PPV of 89.0%, NPV of 98.3%, and diagnostic accuracy of 97.6%. Specific sensitivities and specificities were noted for acute appendicitis, bowel perforation, and ectopic pregnancy. Significant correlation was found between ultrasound and surgical diagnoses for most conditions, except for appendiceal abscess.
Conclusion
The study concludes that with skilled personnel, there is high concordance between ultrasound and surgical diagnoses of acute abdomen. Ultrasonography should be part of the initial evaluation in settings where CT is not readily available, accessible, or affordable.
