Accuracy evaluation of the Ultrasonographic diagnosis in acute cholecystitis at Phramongkutklao hospital
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Abstract
Objective: To evaluate the accuracy of ultrasonographic criteria for diagnosis of acute cholecystitis in Phramongkutklao hospital by comparing with pathological findings in the case of undergoing cholecystectomy or with final diagnosis in medical record in the case of non-operative management.
Methods: As a prospective diagnostic study, a total of 89 patients who were admitted in Phramongkutklao hospital during January, the 1st and December, 31st 2017 with right upper quadrant pain and clinical suspicion of acute cholecystitis enrolled in this study. Their ultrasonographic findings of upper abdomen were recorded and interpreted according to the currently employed ultrasonographic criteria for diagnosis of acute cholecystitis. Major (Gallstones, positive sonographic Murphy’s sign) and minor (Gallbladder wall thickening, pericholecystic fluid, Gallbladder distension) ultrasonographic signs were evaluated. All patients were monitored and followed up until the definite diagnosis were made either by pathological results in the case of surgical management or by final diagnosis in medical record after the end of medical treatment.
Results: The currently used ultrasonographic criteria in department of diagnostic radiology, Phramongkutklao hospital have an accuracy of 87.6%, sensitivity of 80.6%, and specificity of 91.3%.
Conclusion: The currently used ultrasonographic criteria possess a high accuracy for diagnosis of acute cholecystitis. Amongst ultrasonographic signs, positive sonographic Murphy’s sign showed the highest positive predictive value.
Keywords: Acute cholecystitis, Ultrasonographic criteria for diagnosis, Major and minor ultrasonographic signs
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References
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