Comparison of Abdominal Ultrasound and Abdominal Computed Tomography Findings with Colonoscopy Features in the Diagnosis of Inflammatory Bowel Disease at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
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Date
2024-03
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Addis Ababa University
Abstract
Background: Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the
gastrointestinal tract. It mainly includes ulcerative colitis and Crohn's disease. The mainstay
for the diagnosis of inflammatory bowel disorders is currently colonoscopy. Nevertheless,
colonoscopy is a costly, time-consuming, and invasive procedure that patients might not always
tolerate. As a result, there is increased interest in non-invasive diagnosing and monitoring
techniques such as ultrasonography and computed tomography. However, there is a lack of
studies on the comparison between abdominal ultrasound and Computed tomography scan
findings with colonoscopy in the diagnosis of inflammatory bowel disease in Ethiopia. The
study aims to investigate the correlation between abdominal Ultrasound and Computed
tomography scan findings with colonoscopy in diagnosing inflammatory bowel disease among
patients who presented with signs and symptoms suggestive of inflammatory bowel disease at
TASH, Addis Ababa, Ethiopia.
Objective: to assess the comparison of abdominal ultrasound and abdominal computed
tomography findings with colonoscopy in diagnosing inflammatory bowel disease among
patients who presented with symptoms suggestive of inflammatory bowel disease at TASH,
Addis Ababa, Ethiopia.
Method: A 6 year retrospective cross sectional study was employed from May 2023 to March
2024 among 120 patients who presented with symptoms suggestive of inflammatory bowel
disease at TASH. The data was collected using a standardized questionnaire from the medical
records starting from January 01, 2018 to December 30 2023 of patients who underwent
abdominal ultrasound, abdominal computed tomography and colonoscopy for suspected IBD.
The collected data was entered after checked for completeness, then using SPSS 26,
descriptive analysis was applied through frequency, percentage mean and standard deviation.
Statistical analysis was employed to see the each test’s diagnostic accuracy through sensitivity,
specificity, positive and negative predictive values and accuracy for both ultrasound and
computed tomography in comparison to colonoscopy which was used as a gold standard
reference for IBD diagnosis. Finally the result was presented using tables, charts and bars.
Result: IBD was finally diagnosed in 79.2% of the total cases. Sensitivity, specificity, accuracy,
PPV, and NPV were used to evaluate the diagnostic accuracy of each test. The results of our
final analysis indicated that Abdominal CT scan had the following values for sensitivity,
specificity, accuracy, PPV and NPV: 73.4%, 44.0%, 67.5%, 83.3%, and 30.6%; while
Abdominal US had these values at 55.8%, 72.0%, 59.2%, 88.3%, and 30.0%, respectively. The
degree of agreement was as follows: for abdominal US, kappa=0.183, there was a significant
association and slight agreement; for Abdominal CT scan, kappa=0.152, there was no
significant association and slight agreement.
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Keywords
Ultrasound, Computed Tomography, Colonoscopy, Inflammatory Bowel Disease, Diagnostic Accuracy, Correlation, Ethiopia