An Observational Study Of Ultrasonography And Computed Tomography Imaging Findings In Pediatric Blunt Abdominal Trauma At Department Of Radiodiagnosis, Sms Medical College And Hospital, Jaipur
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Date
2024-12
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Indian Society for Health and Advanced Research
Abstract
Introduction Blunt abdominal trauma in the pediatric population is challenging to diagnose due to the unique anatomical and physiological characteristics of children. Ultrasonography (US) and computed tomography (CT) are critical imaging tools for assessing intra-abdominal injuries. While CT provides detailed and accurate assessment of abdominal trauma, it exposes pediatric patients to ionizing radiation. US is a rapid, cost- effective, and radiation-free alternative, but its sensitivity and specificity in pediatric trauma remain debatable. This study compares the diagnostic efficacy of US and CT in detecting intra-abdominal injuries in pediatric patients. To evaluate and compare the sensitivity andAim and Objectives: specificity of ultrasonography and computed tomography in diagnosing pathology in pediatric blunt abdominal trauma. Materials and Methods: This observational study included 70 pediatric patients under 18 years of age presenting with blunt abdominal trauma at SMS Medical College, Jaipur, between 2022 and 2024. Ultrasonography was performed using HITACHI PREIRUS and HITACHI ARIETTA 65 devices, while CT scans were conducted using a GE 16-slice CT scanner. The findings of both modalities were compared, with CT serving as the gold standard. Statistical analysis included sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa coefficient for agreement. Results:The mean age of the study population was 8.54 ± 3.2 years. High kappa values (ranging from 0.731 to 0.804) indicate good agreement between US and CT findings for various injuries (free fluid, liver, spleen, and kidney injuries). Ultrasound shows high overall accuracy (87.3%) and sensitivity (95.3%) for detecting pathologies. Specificity was lower for free fluid (80.5%) and spleen injuries (80.5%). Positive predictive value (PPV) and negative predictive value (NPV) were generally high, indicating reliable detection by ultrasound, though CT remains more accurate for certain injuries. While US was effective in detecting free intraperitoneal fluid, its sensitivity for solid organ injuries was limited compared to CT. CT demonstrated superior sensitivity for detecting complex injuries, including mesenteric, pancreatic, and bowel injuries. CTConclusion: remains the diagnostic tool of choice for hemodynamically stable pediatric patients with blunt abdominal trauma due to its high sensitivity and specificity. However, ultrasonography, particularly in the form of Focused Assessment with Sonography for Trauma (FAST), serves as a valuable initial screening tool in hemodynamically unstable patients. The integration of clinical findings with imaging results is essential to optimize management while minimizing unnecessary radiation exposure.
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Keywords
Pediatric blunt abdominal trauma, ultrasonography, computed tomography, diagnostic efficacy, intra-abdominal injuries, radiation safety.
Citation
Beniwal Ashok Kumar, Jakhar Sunil, Bhandari Annu, Mannan Naima . An Observational Study Of Ultrasonography And Computed Tomography Imaging Findings In Pediatric Blunt Abdominal Trauma At Department Of Radiodiagnosis, Sms Medical College And Hospital, Jaipur. International Journal of Scientific Research. 2024 Dec; 13(12): 70-74