Role of Computed Tomography Scan in Abdominal Trauma
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Background: Abdominal trauma may result in clinically important solid-organ, bowel, mesenteric, vascular, and retroperitoneal injuries that require rapid and accurate diagnosis. Computed tomography (CT) is widely used for anatomical assessment of hemodynamically stable trauma patients, but its diagnostic performance should be evaluated against definitive reference findings. Objective: To determine the diagnostic accuracy of CT for detecting intra-abdominal injury in patients with abdominal trauma using exploratory laparotomy as the reference standard. Methods: This cross-sectional diagnostic-accuracy study included 331 adults aged 18–65 years presenting to Lady Reading Hospital, Peshawar, from 20 September 2024 to 20 April 2025. Participants were recruited consecutively and underwent abdominal CT before exploratory laparotomy. Sensitivity, specificity, positive predictive value, negative predictive value, overall accuracy, and the association between CT and operative findings were evaluated. Results: Laparotomy confirmed intra-abdominal injury in 184/331 (55.6%) patients. CT produced 170 true-positive, 20 false-positive, 14 false-negative, and 127 true-negative results. Sensitivity was 92.4% (95% CI: 87.6–95.4), specificity 86.4% (79.9–91.0), positive predictive value 89.5% (84.3–93.1), negative predictive value 90.1% (84.0–94.0), and overall accuracy 89.7% (86.0–92.6). CT and laparotomy findings were strongly associated (χ²=207.44, df=1, p<0.001). Conclusion: CT demonstrated good diagnostic performance for detecting intra-abdominal injury in this surgically evaluated abdominal-trauma population. Its findings should be integrated with clinical assessment and interpreted within the context of patient selection and injury pattern
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