Diagnostic Value of Physical Examination, Ultrasound, and Radiography Compared to Computed Tomography in the Evaluation of Nontraumatic Left Lower Quadrant Acute Abdominal Pain.

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
Emergency Medicine International Pub Date : 2025-06-09 eCollection Date: 2025-01-01 DOI:10.1155/emmi/1681801
Fakhroddin Kiani, Seyed Mostafa Meshkati Yazd, Fatemeh Zarimeidani, Rahem Rahmati, Nafiseh Shabani Mofrad, Mehdi Vafaei Nia, Reza Shahriarirad
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引用次数: 0

Abstract

Background: Acute abdominal pain (AAP) is a common complaint of emergency department patients. An accurate diagnosis is even more crucial when AAP is associated with left lower quadrant (LLQ) pain, which has a wide variety of differential diagnoses from self-limiting to life-threatening diseases. This study aimed to evaluate the diagnostic efficacies of physical examination (PE), plain abdominal radiography (PAR), and ultrasonography (US) compared to the computed tomography (CT) scan in patients with nontraumatic LLQ AAP coming into the emergency department. Methods: This prospective cross-sectional study was performed on 220 patients with LLQ-AAP for > 2 h and < 5 days who underwent PAR, US, and CT after PE. An expert surgeon assigned a final diagnosis. Test characteristics, including diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative PV (NPV), were calculated for PE, PAR, and US, using a CT scan as the gold standard. Results: Among 220 patients (mean age of 48.17; 55.5% female), PE, PAR, and US yielded an overall accuracy of 30.91%, 35.91%, 50.91%, sensitivity of 75.47%, 62.26%, 39.62%, specificity of 16.77%, 27.54%, 54.49%, PPV of 22.35%, 21.43%, 21.65%, and NPV of 68.29%, 69.70%, and 73.98%, respectively. Conclusions: As a result of the highest sensitivity for PE and the highest accuracy for the US, we suggest considering PE as the primary investigation for identifying urgent conditions in patients with LLQ AAP and the US for an accurate diagnosis rather than PAR.

体格检查、超声和x线摄影与计算机断层扫描对非外伤性左下腹急性腹痛的诊断价值。
背景:急性腹痛(AAP)是急诊科患者的常见主诉。当AAP与左下象限(LLQ)疼痛相关时,准确的诊断就更加重要了,这种疼痛有各种各样的鉴别诊断,从自限性疾病到危及生命的疾病。本研究旨在评估体格检查(PE)、腹部x线平片(PAR)和超声检查(US)与计算机断层扫描(CT)扫描对进入急诊室的非创伤性LLQ AAP患者的诊断效果。方法:本前瞻性横断面研究对220例LLQ-AAP患者进行了前瞻性横断面研究,这些患者在PE后接受了PAR, US和CT检查。一位外科专家给出了最后的诊断。以CT扫描为金标准,计算PE、PAR和US的检测特征,包括诊断准确性、敏感性、特异性、阳性预测值(PPV)和阴性PV (NPV)。结果:220例患者(平均年龄48.17岁;55.5%女性)、PE、PAR、US的总体准确率分别为30.91%、35.91%、50.91%,敏感性分别为75.47%、62.26%、39.62%,特异性分别为16.77%、27.54%、54.49%,PPV分别为22.35%、21.43%、21.65%,NPV分别为68.29%、69.70%、73.98%。结论:由于PE的敏感性和US的准确性最高,我们建议考虑将PE作为确定LLQ AAP和US患者紧急情况的主要调查,以获得准确的诊断,而不是PAR。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Emergency Medicine International
Emergency Medicine International EMERGENCY MEDICINE-
CiteScore
0.10
自引率
0.00%
发文量
187
审稿时长
17 weeks
期刊介绍: Emergency Medicine International is a peer-reviewed, Open Access journal that provides a forum for doctors, nurses, paramedics and ambulance staff. The journal publishes original research articles, review articles, and clinical studies related to prehospital care, disaster preparedness and response, acute medical and paediatric emergencies, critical care, sports medicine, wound care, and toxicology.
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