Diagnostic Accuracy of Ultrasonography Compared with Computed Tomography in Non-Traumatic Acute Abdominal Pain

Background: Non-traumatic acute abdominal pain is a frequent clinical presentation requiring prompt diagnosis to guide appropriate management. Imaging plays a critical role in identifying the underlying pathology. Ultrasonography (USG) is commonly used as the initial imaging modality due to its availability and safety profile, whereas computed tomography (CT) provides detailed anatomical evaluation and higher diagnostic accuracy. This study aimed to compare the diagnostic performance of USG and CT in the evaluation of nontraumatic acute abdominal pain. Material and Methods: This cross-sectional observational study included 150 patients presenting with nontraumatic acute abdominal pain. Clinical details including the nature, duration, and localization of pain were recorded. All patients underwent ultrasonography followed by CT scanning for diagnostic evaluation. The distribution of abdominal pathologies and the sensitivity of USG and CT for different conditions were analyzed and compared. Results: A total of 150 patients were evaluated. Acute pain of <24 hours duration was the most common presentation (48%), followed by subacute pain of 24–72 hours (32%) and chronic pain >72 hours (20%), with a mean pain duration of 31.6 ± 17.2 hours. The most frequent site of pain was the epigastric region (38.6%), followed by the right lower quadrant (24.3%) and flank region (18.3%). Acute pancreatitis was the most common pathology (26%), followed by appendicitis (12.6%), ureteric colic (12%), intestinal obstruction (10%), and acute cholecystitis (10%). Ultrasonography demonstrated variable sensitivity across different conditions, including 56.4% for pancreatitis, 78.9% for appendicitis, 88.9% for ureteric colic, 80% for intestinal obstruction and acute cholecystitis, and 20% for hollow viscus perforation. In contrast, CT showed 100% sensitivity in detecting all evaluated pathologies. Conclusion: Ultrasonography serves as a useful initial imaging modality for patients presenting with nontraumatic acute abdominal pain; however, computed tomography demonstrates superior diagnostic accuracy and remains the preferred modality for definitive evaluation. Keywords: Acute abdomen, ultrasonography, computed tomography, non-traumatic abdominal pain, diagnostic accuracy.