The diagnostic accuracy of preoperative diagnosis in adult male patients with non-traumatic acute abdominal conditions

Abstract EN

The term “acute abdomen” denotes any sudden spontaneous non-traumatic disorder whom the chief manifestation is in the abdomen.

There is frequently a progressive underlying intra-abdominal disorders, therefore the early diagnosis and treatment of such conditions are essential for a favorable outcome.

Abdominal pain is a common presentation that requires almost immediate management.

Diagnosis of acute abdomen before laparotomy is essential in reducing the morbidity, mortality and at the same time in preventing unnecessary operations, especially when the diagnostic facilities are limited and clinical awareness plays an important role in the diagnosis and management.

To evaluate the diagnostic accuracy of the preoperative assessment with the operative diagnosis of adult male patients with non-traumatic acute abdominal conditions.

This is a prospective study conducted at the ALSader medical city during the period from 1st.of December 2012 to 1st.

of December 2014.

The study included 65 patients with clinical manifestations suggestive of acute abdomen that require exploratory laparotomy, while any patients with trauma to the abdomen, previous laparotomy, acute abdomen of medical causes and those below 12 years old were excluded from the study.

Acute abdomen was more common in the age group 20-39 years.

This study revealed that acute appendicitis was the cause of acute abdomen in 52.3 %.

Other common causes of acute abdomen were perforated viscus / peritonitis 18.46 % and intestinal obstruction 15.38 %, .

Leukocytosis has a sensitivity of 36.8 % and a specificity of 66.6 %.

UA has a sensitivity of 50% and a specificity of 77.1%.

US has a sensitivity of 66% and a specificity of 75 %.

Erect chest X-ray has a sensitivity of 20 % and a specificity of 92.5 %.

Supine/erect plain abdominal X-rays has a sensitivity of 63.6% and a specificity of 93.02 %.

This study showed that the overall diagnostic accuracy of preoperative assessment was 86.15 %.

The diagnostic accuracy of perforated viscus / peritonitis was 100 %, the diagnostic accuracy of intestinal obstruction was 83.33 %, while the diagnostic accuracy of acute appendicitis was 82.92 %.