Is There a Correlation between Computed Tomography Scanning of the Acute Abdomen and Associated Surgical Outcomes?

Full Article

SY Tan, BP Waxman

Hong Kong J Radiol 2015;18:282-6

DOI: 10.12809/hkjr1515301

Objectives: To determine the correlation between computed tomography (CT) scanning in evaluating the acute abdomen and the associated surgical outcome.

Methods: This was a retrospective observational study of 362 patients (198 females, 164 males) admitted with an acute abdomen and underwent surgery to the Acute General Surgery and Colorectal Units at Dandenong District Hospital, Australia, between 1 January 2012 and 30 June 2012. Overall, 100 patients (case group) underwent an inpatient preoperative CT scan whereas 262 patients (control group) did not. Surgical outcome was compared between the case and control groups. In the case group, CT diagnosis was compared with the final surgical diagnosis to generate diagnostic performance parameters.

Results: CT scanning of the acute abdomen had an accuracy of 88%, sensitivity of 88%, and specificity of 100%. The most common cause of the acute abdomen in both case and control groups was appendicitis. The mean length of hospital stay was 4.0 days in the control group and 9.6 days in the case group. Surgical outcome was worst in the case group for patients aged over 31 years, although rates of reoperation and intensive care unit stay were higher in those aged over 60 years in the control group. Differences in surgical outcome were not statistically significant.

Conclusion: CT scanning of patients with an acute abdomen improves diagnostic performance and should be used as an adjunct to clinical evaluation if the benefits outweigh the risks. Surgical outcome in the acute abdomen is not influenced by preoperative CT scanning.





SY Tan, BP Waxman