Preethi, Krishnaraj (2020) A Correlative study of Clinical, Biochemical, Radiological, Diagnosis with Operative Diagnosis of Acute Abdomen. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
INTRODUCTION: The term acute abdomen refers toa clinical presentation that often requires emergency surgical therapy. This challenging clinical scenario requires a thorough and expeditious workup to determine the need for operative intervention and to initiate appropriate therapy. AIM AND OBJECTIVES: 1. This study is aimed to correlate the clinical examination, biochemical investigations and radiological findings with operative diagnosis of acute abdomen. 2. To estimate the sensitivity, specificity and accuracy of biochemical diagnosis in acute abdomen. 3. To estimate the sensitivity, specificity and accuracy of radiological diagnosis in acute abdomen. 4. To know the importance of clinical examination in acute abdomen. MATERIALS AND METHODS: 162 patients admitted inTirunelveli medical college with signs and symptoms of acute abdomen were included in the study. A clinical and radiological diagnosis was made for each patient and was compared with the operative diagnosis. RESULTS: Out of 162 patients, 83 patients who were clinically diagnosed as acute appendicitis, intra operatively acute appendicitis was found in 78 patients (93.9%), and 5 patients had appendicular perforation (6.02%). Out of 15 patients clinically diagnosed to have appendicular perforation, all had appendicular perforation intraoperatively (100%). Out of 35 patients with clinical diagnosis of perforative peritonitis, all had found to have perforation intraoperatively (100%) (duodenal perforation-22; gastric perforation-10; ileal perforation-3). CONCLUSION: Clinical examination was found to be statistically correlating with the intraoperative findings.Radiological investigations like USG had high sensitivity for appendicitis but overall low specificity.Erect x-ray was diagnostic of perforation and intestinal obstruction.CT scan was superior when compared with x-ray and USG. Clinical judgement is key to the diagnosis of acute abdomen with biochemical and radiological investigations only aiding in its management and cannot replace the clinical decision.Despite the improvements in technology and time constraints, clinical examination of the patient remains noteworthy in making a diagnosis.Thus clinical examination remains gold standard in making a diagnosis of acute abdomen.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221711366 |
| Uncontrolled Keywords: | Acute abdomen, Clinical examination, Investigations, Radiological findings. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 11 Feb 2021 02:29 |
| Last Modified: | 11 Feb 2021 02:29 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14044 |
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