Role of MDCT (128 Slice Scanner) in Acute Abdomen

Background: Acute abdomen is a clinical condition characterized by the sudden and severe abdominal pain related symptoms typically requires urgent intervention. The term gained prominence in the 20th century and highlights the urgency associated with such presentations. Abdominal pain can arise from a wide spectrum of causes, ranging from minor self-limiting conditions to serious, life-threatening disorders. In cases of severe, diffuse abdominal pain, common underlying causes include acute pancreatitis, bowel perforation, ruptured abdominal aortic aneurysm, and acute mesenteric ischemia (AMI). Aims of this study was to assess the diagnostic precision of 128-slice MDCT in detecting the underlying etiologies of acute abdominal conditions, examine the capability of MDCT in differentiating among various disease processes leading to acute abdominal presentation and investigate the sensitivity and specificity of MDCT in acute abdomen evaluation, using operative, histological, or clinical findings as benchmark standards. Methods: The present prospective study was conducted from August 2023 to April 2025, involving patients referred to the Department of Radiology, DMCH, Laheriasarai, and Bihar, who presented with clinical features suggestive of acute abdomen and underwent MDCT evaluation. Imaging was done with the GE Revolution EVO 128-slice CT machine. The CT findings were subsequently correlated with intraoperative observations, clinical diagnoses, and available histopathological results to assess the diagnostic accuracy and effectiveness for acute abdominal conditions. Results: Evaluation of 106 patients done using Multi-Detector CT. The MDCT results were correlated with operative findings, tissue biopsy reports, and the clinical progress of patients who received non-surgical (conservative) management. 27 patients were females and 79 were males. Youngest patient had an age of 7 years to eldest patient having age of 82 years. Most common causes of acute abdomen were appendicitis in 22%, acute pancreatitis in 15%, acute and bowel obstruction in18%. In our study the sensitivity, specificity and positive and negative predictable values of MDCT were 98.03%, 75%, 99% and 60% respectively. Conclusion: We conclude that MDCT has high sensitivity and accuracy rate. In inconclusive cases, MDCT is recommended to arrive at a definitive diagnosis. The results obtained in the study were comparable to pioneer studies conducted worldwide.