A comparative study of pre - operative with operative diagnosis in acute abdomen.
ABSTRACT: Acute abdomen is one of the commonest surgical conditions we come across in Accident and emergency Department. It is also the commonest operation performed by a surgeon. Diagnostic error and negative laparotomy rate have been consistently high in the past century despite development and n...
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| 语言: | English |
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c2001.
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| 总结: | ABSTRACT: Acute abdomen is one of the commonest surgical conditions we come across in Accident and emergency Department. It is also the commonest operation performed by a surgeon. Diagnostic error and negative laparotomy rate have been consistently high in the past century despite development and new inventions high in the past century despite development and new inventions in the investigative modalities. The aim of this study was to observe the pre-operative diagnostic accuracy compared to operative findings and the rate of negative laparotomy in our setup. Study was also done to evaluate the predictive values of different investigations performed in acute abdomen. 102 patients of all age group with non-traumatic acute abdomen were studied over a period of 6 month (1st Shrawan 2057 BS to .29th Paush 2057 BS). The disease was most common in the age group 20-29 years with male predominance. More than half of the acute abdomen was observed due to the acute appendicitis. Overall diagnostic accuracy was 78.4%. This difference in pre-operative and operative diagnosis is statistically significant (p<0.05). Diagnostic accuracy was highest in bowel obstruction (82.4%) and lowest in peritonitis due to viscus perforation (69.0%). Negative laparotomy rate was 9.8% in the study while avoidable laparotomy rate was 6.9%. Highest rate of negative laparotomy was observed ion patients with acute appendicitis while highest rate of avoidable laparotomy was seen in patient with peritonitis. Total Leucocyte count and Neutrophil Leucocyte count were most sensitive in evaluating patens with acute appendicitis while PAX had highest sensitivity in evaluating patients with bowel obstruction. USG abdomen had high specificity as well as positive and negative predictive values in evaluating patients with acute appendicitis. |
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| Item Description: | Thesis Report. |
| 实物描述: | 57p. : |