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

Abstract

Background: Acute cholecystitis is the most frequent illnesses that necessitate surgical procedures in an emergency. Research indicates that performing cholecystectomy at an early stage leads to improved results, reduced hospital stays, and lower healthcare expenses. Early diagnosis is crucial during the presentation of a patient in the emergency ward and can be achieved by a precise clinical examination and the use of suitable diagnostic procedures. Ultrasound is regarded as the ideal initial imaging approach for individuals suspected of acute cholecystitis clinically. Objective: To examine the diagnostic precision of emergency sonographic signs in patients with suspected acute cholecystitis, while considering histopathology as the gold standard. Methods: A cross-sectional study at the selected hospital of Karachi conducted over one year, on 103 patients who met the diagnostic criteria. Mean and standard deviation for continuous data and frequencies with percentages were calculated for categorical data. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy were measured. A p-value of ≤0.05 is significant. Results: 47 (45.6%) were male and 56 (54.4%) were female. The mean age 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 keeping 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 methodology will enhance the quality of medical care and increase patient safety

Keywords

• acute cholecystitis
• emergency sonographic signs
• ultrasound
• histopathology
• right hypochondrial pain.