Visualization plays an important role in patient management tactics due to the possible inaccuracy of examination data. Conducting a CT scan is the most important, as a CT scan provides an accurate and statistically reliable diagnosis in an emergency situation.
The use of CT in the diagnosis of acute abdomen has recently increased significantly. For example, in the United States, the number of CT scans for acute abdomen increased by 141% from 1996 to 2005. This growth is due to the high accuracy of CT in the diagnosis of specific conditions (for example, appendicitis , diverticulitis, etc.) and high productivity of multidetector CT.
... In a study with a cohort of 1021 patients with an acute abdomen, the results of ultrasound and CT in the diagnosis were compared. CT was significantly more sensitive compared to ultrasound (89% vs. 70%). The highest sensitivity was achieved using the following diagnostic strategy: first ultrasound, then, in case of a negative or inconclusive result - CT.
Previously, acute appendicitis was diagnosed on the basis of clinical data. As a result of the assumption that missed appendicitis, and therefore the possibility of perforation, have more negative consequences than appendectomy with a normal appendix, the threshold of indications for surgery was quite low.
... CT showed a high diagnostic accuracy, with a sensitivity of 92% and a specificity of 99%. In patients with acute abdominal syndrome, CT showed a diagnostic accuracy of acute cholecystitis comparable to ultrasound. The primary imaging modality for patients with suspicion of acute cholecystitis <nevertheless> should be ultrasound.
CT has the highest diagnostic accuracy of small bowel obstruction, sensitivity - 94%, specificity - 96%.
CT is an effective diagnostic method that has a positive effect on the treatment of a large number of patients with acute abdominal syndrome. Currently <2010> CT is the primary diagnostic modality for patients with acute abdominal syndrome, except in patients with suspected acute cholecystitis, when US is the preferred modality, although CT remains an acceptable alternative.
CT is the best method for diagnosing appendicitis in the US, which led to a decrease in "erroneous" appendectomies from 24% to 3%, correspondingly, the use of CT increased from 20% to 85% over a 10-year period.
Moreover, it was established that the routine use of CT is economically justified due to the reduction of in-hospital costs for unjustified hospitalizations and operational-diagnostic manipulations.
CT plays a certain role in confirming the diagnosis and staging in suspected complicated course of diverticulitis. CT provides information for determining tactics and in differential diagnosis, in accordance with the recommendations of the American Association of Colorectal Surgery.
Assessment of the concentration of extraluminal gas inclusions, a local defect of the intestinal wall and segmental thickening of the intestinal walls allow to increase the accuracy of establishing the localization of perforation of a hollow organ (large or small intestine, stomach, etc.)
Currently, CT is the method of choice for establishing the cause, severity, location, and distribution of ischemic bowel changes.
656 views
