Assessment of Blunt Abdominal Trauma, A Comparative Analysis of Contrast-Enhanced CT and Ultrasonography in Terms of Sensitivity, Specificity, and Patient Outcomes

Abstract

Introduction: A prompt and precise diagnosis is necessary for blunt abdominal trauma (BAT), a major source of morbidity and death. With an emphasis on sensitivity, specificity, and patient outcomes, this study evaluates the diagnostic performance of contrast-enhanced computed tomography (CECT) and ultrasonography (US) in evaluating BAT.

Methodology: 84 BAT patients from the Federal Govt Polyclinic Hospital in Islamabad participated in this prospective, comparative research between January and August 2024. Every patient had a first US and then CECT. Using CECT results as the gold standard, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of US were computed. Analysis was done on clinical outcomes, such as hospital stays, surgical procedures, and death.

Results: US had an 89.7% sensitivity and an 84.6% specificity for detecting free intra-abdominal fluid. Nevertheless, it failed to detect six retroperitoneal hemorrhages and ten minor solid organ damage detected by CECT. CECT has a sensitivity of 97.8%, demonstrating excellent accuracy for detecting solid organ damage. The CECT-guided group had a greater rate of surgical intervention (36.9%) than the US group (32.1%). Despite significantly longer hospital stays for individuals with a CECT diagnosis, the two groups' death rates were similar.

Conclusion: Because of its great sensitivity for detecting free fluid, ultrasonography is a useful first screening method for BAT. However, because of its greater diagnostic accuracy, especially for solid organ and retroperitoneal injuries, CECT is still necessary for a thorough examination.