PLACE DE L’IMAGERIE DANS LE DIAGNOSTIC DES DOULEURS ABDOMINALES AIGUËS DE L’ADULTE AUX URGENCES CHIRURGICALES DE L’HOPITAL ARISTIDE LE DANTEC

Aim : To report the imaging strategies in the diagnosis of acute non-traumatic acute abdominal pain in adult patient. Patients and methods: We performed aforward-looking study over a period of 12 months including 153 patients. The inclusion criteria were the presence of abdominal pain evolving for less than 7 days without abdominal trauma and an age of 16 year and over. The imaging exams, the modalities of their association, their indications as well as their results were reported. Results: One hundred and thirty-one patients (85,6%) had imaging exams. Ninety seven patients (61%) had an ultrasound done, 47 patients (29,6%) had a plain abdominal radiography, whereas computed tomography was done in 15 patients (9,4%).Ultrasound was performed alone in 73 patients (45,9%), plain abdominal radiography as well in 27 patients (17%) and computed tomography in 4 patients (2,5%). Plain abdominal radiography was associated to ultrasound in 16 patients (20,2%), and to computed tomography in 3 patients (3,8%). Ultrasound and computed tomography were associated in 7patients (8,8%) whereas the 3exams were associated in 1 patient (1,4%).The affections for which plain abdominal radiography was performed were: bowel obstruction (n=23), peritonitis(n=17), appendicitis (n=3), non-specific abdominal pain (n=3) and cholecystolithiasis(n=1). Ultrasound was realized for appendicitis (n=50), peritonitis (n=15), gynecological peritonitis, urinary lithiasis and liver steatosis (n=1) in each case. Computed tomography was performed for bowel obstruction (n=10), peritonitis, strangulated eventration, appendicitis, necrobiotic fibroma of the uterus and non-specific abdominal pain (n=1) in each case. Plain abdominal radiography found abnormal results in 38 patients (80.8%); while ultrasound and CT suggested a correct diagnosis in 72.4% and 80% of cases respectively. Conclusion: Imaging is an important diagnostic tool for acute abdominal pains. Ultrasound and plain abdominal radiography are the commonest exams. Key-words: acute abdominal pain, imaging, ultrasound, computed tomography, plain abdominal radiography.