Role of Plain X-ray Abdomen and Ultrasonography in Diagnosis of Non-Traumatic Acute Abdomen Compared with Operative Findings

Introduction: Following history taking and clinical examination, plain x-ray abdomen and ultrasound have traditionally been the first line and most useful methods of further investigations for acute abdomen. Though sometimes it needs expert clinical eye and modern machineries to prove it and compare with operative findings. Objective: This study was conducted to assess the usefulness of ultrasonography (USG) and plain x-ray abdomen in the evaluation of non-traumatic acute abdomen. Methodology: This cross-sectional study was conducted among purposively selected 72 clinically diagnosed non-traumatic acute abdomen patients attending in emergency department of Dhaka Medical College and Hospital (DMCH) who went for surgery, during the period of 15 months from June 2012 to September 2013 Results: Among the subjects’ majority 52(72.2%) were male and 36(50.0%) were 21 to 30 years’ age group. Plain x-ray abdomen showed, 18(25.0%) had intestinal perforation, 12(16.66%) had gall stone, 32(44.44%) had normal findings and rest 10(13.88%) had other findings. On the other hand, USG showed 14(19.44%) had acute appendicitis, 12(16.66%) had acute intestinal obstruction, 10(13.88%) had acute cholecystitis, 17(23.61%) had normal findings and rest 19(26.38%) had other findings. Per operative diagnosis found that 18(25.0%) had perforation, 16(22.22%) had appendicitis, 12(16.66%) had intestinal obstruction, 10(13.88%) had acute cholecystitis and rest had other findings. This study revealed thatsensitivity & specificity of plain x-ray abdomen, USG and combined both test in diagnosis of nontraumatic acute abdomen was 61.29% & 80.0% and 83.8% & 70.0% and 96.0% & 80.0% respectively. Conclusion: Plain x-ray abdomen and USG are the useful easily available, cheap diagnostic tools for diagnosing non-traumatic acute abdomen and help to prevent negativelaparotomies.