The role of MSCT in the diagnosis of nontraumatic acute abdominal pain

The role of MSCT in the diagnosis of nontraumatic acute abdominal pain

Shabunin A.V., Вagateliya Z.A., Arablinskii A.V., Magdebura Yu.A.

Purpose. To perform the possibility of MSCT in identifying the cause of acute abdominal pain (AAP) in patients without a history of trauma.

Materials and methods. The results of MSCT of the abdominal and pelvis were analyzed in 880 patients with acute abdominal pain, admitted to the State Clinical Hospital. S.P. Botkin admission department in 2018. All patients performed chest and abdominal radiography and US as first-line methods after the initial examination by the surgeon. When there was a lack of data for the diagnosis, CT studies were performed on a 128-slice Phillips Ingenuity Core, natively, with oral and/or intravenous administration of a water-soluble, nonionic iodine-containing contrast medium, depending on the suspected pathology. All MSCT results were compared with the documented final diagnosis.

Results. According to MSCT, the structure of the incidence in the studied group of patients looked as follows: acute intestinal obstruction (including tumor) - 27%, acute pancreatitis - 9%, renal colic - 8%, tumors of the abdominal cavity (including metastatic parenchymal lesions organs, but excluding stenosing gut lumen) - 7%, intraabdominal abscesses (parenchymal organs and paracolic) - 6%, violations of mesenteric blood supply - 3%, inflammatory changes in the bile duct and gall bladder - 3%, hollow organ perforation 2%. 5% of patients had no convincing data for the presence of pathological changes in the abdominal and pelvic organs, while maintaining the clinical picture of the acute abdomen. The diagnostic efficiency of MSCT for these diseases ranged from 95% to 97%, the sensitivity and specificity of the method, depending on the disease, were 95-97.8% and 93.2-97%, respectively, p> 0.05.

Conclusion. With ambiguous clinical, laboratory data and the results of first-line medical imaging methods (radiography, ultrasound), MSCT exhibits high information value and accuracy, which makes it possible in the shortest time to diagnose and prescribe timely, adequate treatment in patients with acute abdominal pain without a history of injury.

1 - S.P. Botkin Moscow City Clinical Hospital.

2 - Russian Medical Academy of Continuous Professional Education.

3 - I.M. Sechenov First Moscow State Medical University.

Moscow, Russia.

 

Keywords: MSCT, AAP, acute abdomen, emergency medicine.


Corresponding author:  Magdebura Yu.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Shabunin A.V., Вagateliya Z.A., Arablinskii A.V., Magdebura Yu.A. The role of MSCT in the diagnosis of nontraumatic acute abdominal pain. REJR 2019; 9(2):119-129. DOI:10.21569/2222-7415-2019-9-2-119-129.

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Received:        22.05.19 Accepted:       08.07.19