Correlation and diagnostic accuracy of CT in the acute surgical

Published Date: 19th July 2016

Publication Authors: Rajaganeshan R, Wellens T

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Aim 

CT in the acute surgical presentation has significantly increased with technological advancement and availability. Emergency CT is reported by the on call radiologist of varying seniority. We undertook a retrospective study to compare the correlation with the initial senior clinicians' diagnosis and the eventual laparotomy findings. 

Method

Retrospective data collection was performed of 100 sequential acute surgical admissions who underwent emergency CT followed by subsequent laparotomy since August 2013. Data was collected via standard proforma using electronic records, patients were characterised according to gender, age (age > 70 years defined as elderly) and ASA. Four patients were excluded with incomplete data.

Results

Mean age was 63 years with a trend to younger age group (60%). Median ASA for the young cohort was 2 and elderly cohort 3. There was no significant difference in critical care admission. There were 14 mortalities in the elderly and 7 in the young cohort. Within the < 70 year olds, clinical diagnosis and CT had a positive correlation in 57.1% (32/56) and with laparotomy 53.6% (30/56). CT scan correlated directly with laparotomy in 84% (47/56). Within > 70 year olds, clinical diagnosis and CT had a positive correlation in 57.5% (23/40) and with laparotomy 62.5% (25/40). CT scan correlated directly with laparotomy in 85% (34/40).

Conclusion

CT accuracy is greater than initial clinical diagnosis within both cohorts, however, there are marked differences in CT and clinical finding correlation. This study is a pilot for a prospective large trial to evaluate the requirement for acute GI radiology reporting.

Hargreaves, A; Hancorn, K; Wellens, T; Heneghan, S; Rajaganeshan, R. (2014).  Correlation and diagnostic accuracy of CT in the acute surgical presentation . Colorectal Disease. 16 (Supplement S2), 147

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