DIAGNOSTIC ACCURACY AND CLINICAL IMPACT OF COMPUTED TOMOGRAPHY IN PATIENTS PRESENTING WITH ACUTE ABDOMINAL PAIN: A CROSS-SECTIONAL STUDY FROM A TERTIARY CARE HOSPITAL IN FAISALABAD, PAKISTAN

Abstract

Background: Acute abdominal pain is a frequent presentation to emergency departments around the world, and the many possible causes of this pain often make clinical assessment alone inadequate for prompt and confident decision making. Computed tomography (CT) is the main cross-sectional imaging modality in solving this diagnostic dilemma, although there is limited evidence locally that is generated regarding the accuracy of this modality and its downstream clinical consequences in Pakistani tertiary care settings.

Objective: To compare the diagnostic accuracy of CT imaging with surgical/clinical reference standard and the effect of CT imaging on management in patients with acute abdominal pain at a tertiary care hospital in Faisalabad, Pakistan.

Methods: The study was descriptive cross sectional, which was conducted for four months from September 2025 to December 2025 in the Department of Radiology, Allied Hospital II, Faisalabad. Patients with symptoms of acute abdominal pain of less than 72 hours duration and referred to the CT abdomen were recruited by consecutive non-probability sampling, total 35 patients were enrolled. Descriptive statistics were used for demographic, clinical and radiological data and to calculate sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) against the surgical/clinical reference standard; the chi-square test and one-way ANOVA were used for analysis.

Results: The cohort comprised 26 men (74.3%) and 9 women (25.7%) with a mean age of 37.4 ± 12.3 years. In 33/35 patients (94.3%), a definite diagnosis was achieved, the most common of which were acute appendicitis (22.9%), intestinal obstruction (17.1%) and acute cholecystitis/renal/ureteric calculus (14.3% each). CT showed a sensitivity of 94.3% (95% CI 80.8–99.3), specificity of 88.6% (95% CI 73.3–96.8), PPV of 93.8%, and NPV of 89.3% against the reference standard, and directly altered clinical management in 30/35 patients (85.7%).

Conclusion: In this group, CT was accurate and also had a material impact when considering clinical decisions as it is known to be the first imaging study to be ordered for an acute abdominal pain. Before drawing conclusions outside of this population, the observed associations between the subgroups need to be confirmed in a larger, multicentre sample.