Acute Abdomen: Analysis of Clinical & Radiological Profile & Its Management

Abstract

Introduction: Acute abdomen is a time-sensitive clinical syndrome requiring prompt evaluation to identify surgical pathology and prevent complications. Clinical examination and imaging jointly guide diagnosis, operative planning, and outcome.

Aim & Objective: To analyse the clinical and radiological profile of acute abdomen, identify its aetiologies and presentations, describe management, and assess the diagnostic accuracy of clinical and radiological findings against intraoperative observations.

Materials & Methods: This hospital-based cross-sectional study was conducted in the Department of General Surgery, Jorhat Medical College and Hospital, Assam, from November 2023 to October 2024. One hundred consecutive patients aged above 12 years presenting with acute abdomen and undergoing laparotomy were enrolled. Pregnant, traumatic, urological, and gynaecological cases were excluded. Clinical findings, laboratory investigations, abdominal radiography, ultrasonography, computed tomography, operative findings, procedures, and outcomes were recorded. Data was analysed using descriptive statistics, chi-square test, and Student’s t-test.

Results: The mean age was 39.20 ± 15.85 years, and 41–50 years was the commonest age group. Abdominal pain and tenderness occurred in 100%, vomiting in 74%, fever in 55%, and guarding in 76%. Acute appendicitis was the commonest operative diagnosis (46%), followed by perforative peritonitis and intestinal obstruction. Clinical diagnosis of appendicitis showed 96% accuracy, 100% sensitivity, and 92.6% specificity, while ultrasonography showed 97% accuracy, 100% sensitivity, and 94.44% specificity. Clinical diagnosis of intestinal obstruction achieved 94% accuracy, while plain radiography showed a 94.44% diagnostic yield. Overall, 97% of patients were discharged, while mortality was 3% across the included surgically managed patient population.

Conclusion: Systematic clinical assessment, appropriate imaging, and timely individualized surgery provided high diagnostic reliability and favourable outcomes in acute abdomen.

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