Publication: A comparative study of pre-operative with operative diagnosis in acute abdomen
Date
2005
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
In this observational study (from August 2000 to January 2001) 102 patients of all age group with non-traumatic
acute abdomen were studied to see the negative laparotomy rate and the diagnostic accuracy and predictive values of
different investigations in acute abdomen. The disease was most common in the age group 20-29 years with male
predominance. More than half of the acute abdomen was due to the acute appendicitis. Neutrophil leucocyte count
had the highest sensitivity (91.5%) while Plain X-ray abdomen showed the highest specificity (88.8%) and positive
predictive value (88.6%) in diagnosing acute abdomen. Urinalysis showed the highest negative predictive value
(93.3%). Overall diagnostic accuracy was 78.4%, which was statistically significant (P<0.05). Diagnostic accuracy
was highest in bowel obstruction (82.4%) and lowest in peritonitis due to viscus perforation (69.0%). Negative
laparotomy rate was 17.6% in the study, which was statistically significant (p<0.05). It was highest with peritonitis
due to viscus perforation (20.7%), and lowest in bowel obstruction (11.8%).
Key words: Acute abdomen, laparotomy.