Diagnostic Performance of Ultrasonography in the Assessment of Interventional/Surgical Causes of Acute Abdominal Pain in Paediatric Age Group

Background: Acute abdominal pain is a common yet diagnostically challenging presentation in the pediatric population, with a wide spectrum of potential causes ranging from benign conditions to surgical emergencies. Accurate and timely diagnosis is crucial to minimize morbidity and guide appropriate intervention. Ultrasonography (USG) has emerged as a frontline imaging modality owing to its safety, availability, and diagnostic capability. Objectives: To evaluate the diagnostic performance of ultrasonography in detecting interventional and surgical causes of acute abdominal pain in children aged 1 to 18 years, and to correlate USG findings with final operative and histopathological diagnoses Materials and Methods: This prospective observational study was conducted in the Department of Radiodiagnosis, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, over a period of two years. A total of 75 pediatric patients presenting with acute abdominal pain underwent abdominal USG. Findings were compared with operative and histopathological results. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for each major condition. Results: USG demonstrated high sensitivity and specificity for acute appendicitis (87.2% and 90%, respectively), intestinal obstruction (85% and 88%), cholelithiasis (86% and 85%), and mesenteric lymphadenitis (84% and 82.3%). A strong correlation was found between USG and final diagnoses (p < 0.001), with an overall USG diagnostic accuracy ranging from 80.6% to 88%. Statistically significant associations were also noted between clinical and ultrasonographic diagnoses (p = 0.002).Conclusion: Ultrasonography is an effective, accurate, and non-invasive diagnostic tool for evaluating pediatric acute abdomen. Its high diagnostic performance supports its role as the primary imaging modality in emergency pediatric settings, aiding in prompt clinical decision-making and reducing unnecessary interventions