Diagnostic Accuracy and Clinical Impact of Multidetector Computed Tomography in Adult Patients with Non-Traumatic Acute Abdomen: A Cross-Sectional Study

Abstract

Background: Non-traumatic acute abdomen is a frequent emergency presentation encompassing a broad spectrum of conditions ranging from self-limiting inflammatory disorders to life-threatening surgical emergencies. Although ultrasonography (USG) and plain abdominal radiography are commonly employed as first-line imaging modalities, their diagnostic performance is often limited. Multidetector computed tomography (MDCT) has emerged as an important imaging tool for establishing an accurate diagnosis and guiding timely management.

Objective: To evaluate the diagnostic accuracy of MDCT in adult patients presenting with non-traumatic acute abdomen and to assess its impact on subsequent clinical management.

Materials and Methods: A hospital-based cross-sectional study was conducted in the Department of Radiology, Mahavir Institute of Medical Sciences, Telangana, between March 2024 and December 2025. A total of 187 adult patients presenting with non-traumatic acute abdomen underwent MDCT following inconclusive, negative, or clinically insufficient conventional imaging. CT diagnoses were compared with operative findings or final discharge diagnoses. The influence of MDCT on patient management was also evaluated.

Results: The mean age of the study population was 45.09 ± 12.32 years, with a slight male predominance (52.94%). Ultrasonography was inconclusive in 58.29% of patients, while abdominal radiographs were normal in 71.12%. MDCT demonstrated diagnostic concordance with the final diagnosis in 97.33% of cases. CT findings altered clinical management in 55.08% of patients, most commonly by changing conservative treatment to urgent surgical intervention. Management modification was significantly associated with underlying etiology (χ²=41.75, p<0.001).

Conclusion: MDCT demonstrated excellent diagnostic accuracy and substantially influenced therapeutic decision-making in adults with non-traumatic acute abdomen. Its high concordance with final diagnosis and significant impact on surgical triage support its routine use when conventional imaging is inconclusive or insufficient.