Comparison of diagnostic efficacy of ultrasound and CT scan in patients with blunt abdominal trauma t Tikur Anbesa comprehensive specialized hospital and AaBET hospital, Addis Aabeba, Ethiopia
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Date
2018-10
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Addis Ababa University
Abstract
Background: Traumatic injuries are a significant public health issue worldwide. Abdomen has ben reported to be the third most common region of injury after head and extremities. Imaging plays a key role in the advanced care of trauma patients. US is a recommended initial imaging modality in the evaluation of blunt abdominal trauma but CT is considered the most accurate imaging method.
Objective: to compare the diagnostic efficacy of ultrasound and CT scan in patients with blunt abdominal trauma Tikur Anbesa comprehensive specialized hospital and AaBET hospital.
Methods: An institution based prospective cross-sectional study was conducted at tikur Anbesa Comprehensive specialized hospital and AaBet hospital using ultrasound (Sonoscape SSI-8000) and CT scan (GE 64-row detector volumetric scanner) was conducted for one-year period from patients who fulfill the inclusion criteria in the study. Data collection of 47 patients was done using a well-designed data collection forms by interview of patients or attendants who presented for ultrasound, review of patient’s medical record chart and review of diagnostic images. Data was then entered using EpiData 3.1, cleaned and analyzed using IBM SPSS version 25 software according to the study objectives.
Results: Total of 47 patients were studied, of which 34 (72.3%) of patients were male and 13 (27.7%) were females with male to female ratio of 2.62:1. The age ranged from 3 months to 69 years with mean of 30.36 year and majority of the study population, 72.4%, were adults aged 18-40 years. The commonest mechanism of injury was road traffic accident taking more than half, 28(59.6%) followed by falling down accidents 11 (23.r%). Hemoperitoneum is the most common finding seen in blunt abdominal trauma patients. The sensitivity and specificity of ultrasound is 76.9% and 90.5% in detecting hemoperitoneum with 8 false negative (23.1%) and 2 false positive (9.1%). Overall 22 organ injuries were detected in 47 patients with CT with sensitivity specificity, Positive and Negative predictive value of 50%, 100% and 69.4% respectively. Conclusion: The present study supports the view that US and CT have complementary rols in the diagnosis of blunt abdominal trauma. Although US can be used as an initial screening method for blunt abdominal trauma to detect presence of free fluid, CT is till the imaging modality of choice for detecting intra-abdominal injuries in stable patients because about a quarter of the patients with blunt abdominal injuries in stable patients because about a quarter of the patients with blunt abdominal trauma may be missed on ultrasound.
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blunt abdominal trauma, road traffic accidents, ultrasound, CT scan, Tikur Anbesa, AaBET, Ethiopia