Comparative Study of Ultrasonography and Computed Tomography in the Evaluation of Blunt Abdominal Trauma at CMS-TH

Abstract

Introduction: This study was conducted to compare the role of USG and CT as noninvasive imaging techniques for assessing the patient with blunt abdominal trauma.

Methods: A prospective longitudinal study was performed at the College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan in the department of Radiodiagnosis, from January 2011 through July 2013. Where 150 patients following abdominal injuries were recorded, including patient age group, sex and mode of injury. Patient underwent USG and CT evaluation. The role of USG and CT was compared in the diagnosis of blunt abdominal trauma.

Results: In our study, 80% of patient with blunt abdominal injury were male with the M:F ratio of 4:1. Road traffic accident was the most common cause of blunt abdominal trauma (72%). There were 95 (92.22%) patients positive for free fluid by USG and CT where 15 had no organ injury. CT revealed organ injuries in 88 (85.43%) patients whereas USG detected 72 (69.90%) organ injuries. Spleen 42 (47.72%) was the most common organ to be injured followed by liver29 (32.95%), kidney 7 (7.9%) and pancreas 3 (3.4%). 16 (18.18%) patients out of 88 positive for organ injuries were not associated with free fluid. Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of USG for organ injury were 81.81%, 100%, 100%, 79.48% and 89.3% respectively.

Conclusions: USG and CT are useful noninvasive tools in detecting free intraperitoneal fluid and organ injuries in patients with blunt abdominal trauma. CT is superior to detect organ injuries in patients with blunt abdominal trauma.