Spectrum of Diseases and Diagnostic Values of Ultrasound in Adult Patients with Nontraumatic Acute Abdomen in a Nigerian Tertiary Health Facility

Abstract

Aim and Objective: The purpose of this study was to determine the spectrum of disease on abdominal ultrasound (US) and the diagnostic efficacy of US in adult patients with nontraumatic acute abdomen at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile‑Ife. Materials and Methods: The study population included consecutive 150 adult patients aged 15 years and above presenting with nontraumatic acute abdomen via the adult emergency unit or as inpatients referred to the Radiology Department of OAUTHC, Ile‑Ife for abdominal US. MINDRAY D.C‑6 real‑time US scanner with 3.5, 5.0, and 7.5 MHz probes and Doppler facilities were used to assess the intra‑abdominal organs and the findings were compared with the clinical and surgical findings in those cases that were operated. Results: The common spectrum of diseases encountered on US in this study included appendicitis (66 [44%]), ectopic pregnancy (34 [22%]), intestinal obstruction (13 [8.7%]) while the least finding was renal abscess 1 (0.7%). The correlation of US findings with surgical findings in this study showed sensitivity, specificity, and kappa agreement for appendicitis of 83.3%, 100.0%, and 0.808; ectopic pregnancy of 100.0%, 97.8%, and 0.958; acute cholecystitis of 100.0%, 100.0%, and 1.0. However, perforated viscus showed the least sensitivity (60.0%), specificity (99.2%), and kappa agreement 0.654. All the disease entities showed good kappa agreement beyond chance, and they were all statistically significant (P < 0.001). Conclusions: This study has shown a relatively high sensitivity, specificity and diagnostic accuracy of US in cases of nontraumatic acute abdomen in a careful hand. We, therefore, recommended that these advantages of US should be capitalized upon in settings where other advanced diagnostic modalities are not available.

Keywords: Accuracy, acute abdomen, Nigeria, spectrum, ultrasound