Diagnostic Value of Plain Abdominal Radiograph In Non Traumatic Causes of Acute Abdomen

Indian Journal of Applied Basic Medical Sciences
Year: 2019, Volume: 21(A), Issue. (1), January
First page: (508) Last page: (525)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi:

Diagnostic Value of Plain Abdominal Radiograph In Non Traumatic Causes of Acute Abdomen
Deepak Rajput1 and Aashaka Patel2*
1Associate Professor, 2Resident, Radio diagnosis Department , L.G. Hospital , Maninagar, Ahmedabad
Corresponding author email id:patelaashaka7993@gmail.com

Online Published on 02-Jan-2019

ABSTRACT

BACKGROUND : Abdominal pain is a common presentation to emergency department. Preoperative diagnosis of acute abdomen is crucial to minimize the morbidity and mortality where the diagnostic facilities are limited. Plain abdominal films are usually recommended for conditions like perforation of GI tract, intestinal obstruction & ureteric calculus on clinical assessment.In India, where availability of MRI & CT in remote areas & affordability of these investigations by poor patients become hindrance to achieve early diagnosis in acute abdominal conditions.METHODS : A total of 336 cases of clinically suspected acute abdomen ( non-traumatic ) underwent routine plain x-ray abdomen. Study was performed between August to October 2018. X-rays were carried out on Allengers 350mA, 500mA & 800 mA machine.RESULTS : Our study showed that among 336 clinicaly suspected cases of acute abdomen , PAR was positive in 63.4 % cases. It was normal or inconclusive in rest 36.6 % cases of clinically suspected acute abdomen. In our study, from total 136 cases of clinically suspected renal or uretreic calculi, 120 (88%) had positive x-ray findings. Further evaluation like ultrasound or CT scan was done of these patients & x ray were true positive in about 90 cases(77%) . In clinically suspected 45 cases of intestinal obstruction , 40 cases (88%) had x ray findings to suggest intestinal obstruction. In follow up of these patients, from 40, 38 patients (95%) were true positive for intestinal obstruction on CT scan. In our study, x rays were 100 % confirmatory for perforation. But , in clinically suspected cases like pancreatitis & cholecystitis only 13% & 23% respectively had positive findings on x-rays.Thus, this study shows that x-rays are confirmatory for cases of perforation. Though , it is reliable for intestinal obstruction & renal stones, it is not confirmatory. Other imaging modalities are necessary to confirm the diagnosis.CONCLUSION : Plain abdominal radiographs(PAR) in cases of acute abdomen are most widely used first imaging modality. It is noninvasive, low cost first line modality & easy to perform imaging modality that can be used in every patients presenting to casuality. PAR are most useful in cases with perforation , intestinal obstruction & renal / ureteric / vesicoureteric junction / urinary bladder calculi.

Keywords

Abdominal,MRI & CT, pancreatitis & cholecystitis,Plain abdominal radiographs.

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