Original Article

Diagnostic Accuracy of Emergency Sonographic Signs in Patients with Suspected Acute Cholecystitis Keeping Histopathology as Gold Standard

Abstract

• Abstract: Background: Acute cholecystitis most frequent condition requiring emergency general surgery. Studies show early cholecystectomy results in better outcomes, a shorter length of stay in the hospital, and lower health costs. It is imperative to make an early diagnosis in the patient’s presentation to the emergency department with the help of an accurate clinical assessment and appropriate diagnostic tests. The US is currently considered the preferred initial imaging technique for patients clinically suspected of having acute cholecystitis. Objective: To determine the diagnostic accuracy of emergency sonographic signs in patients with suspected acute cholecystitis keeping histopathology as the gold standard. Methods: Cross-sectional study was conducted at PNS Shifa Naval Hospital, Karachi on 103 patients who met the diagnostic criteria. Mean and SD for continuous data and frequencies with percentages were calculated for categorical data.. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy were calculated. The P-value of ≤0.05 is significant. Results: 47 (45.6%) were male and 56 (54.4%) were female. The mean age in our study was 47.47±8.57 years and the duration of symptoms was 7.19±2.14 hours. Out of 103 patients, sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of emergency sonographic signs for the diagnosis of acute cholecystitis by taking histopathology as the gold standard was 81.1%, 88.2%, 93.3%, 69.7%, and 83.4% respectively. Conclusion: Emergency sonographic findings are effective in the identification and diagnosis of acute cholecystitis. The histopathological diagnosis correlated well with the ultrasound diagnosis of acute cholecystitis. This approach will contribute to improvement in patient care and increase patient safety.
  
  

• Keywords: Acute cholecystitis, emergency sonographic signs, ultrasound, histopathology, right hypochondrial pain.

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