Diagnostic Value of Peritoneal Nodules Detected on CECT Abdomen in Management of Ascites of Unknown Origin- A Retrospective Study

Introduction: The aetiology of ascites can be established in a majority of patients with routine clinical examination and conventional laboratory and imaging investigations; but in a minority, the cause may remain undetected even after these examinations. This ascites is termed as ascites of unk...

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Main Authors: Naganarasimharaju Jukuri, Ramakrishna Narra, Mary Varunya Jehendran, Yeruva Yeshwanth Reddy, Mahathi Thotakura
Format: Article
Language:English
Published: JCDR Research and Publications Pvt. Ltd. 2022-01-01
Series:International Journal of Anatomy Radiology and Surgery
Subjects:
Online Access:https://www.ijars.net/articles/PDF/2726/49607_CE[Ra1]_F(SHU)_PF1(JY_SHU)_PFA(KM)_PN(SHU).pdf
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author Naganarasimharaju Jukuri
Ramakrishna Narra
Mary Varunya Jehendran
Yeruva Yeshwanth Reddy
Mahathi Thotakura
author_facet Naganarasimharaju Jukuri
Ramakrishna Narra
Mary Varunya Jehendran
Yeruva Yeshwanth Reddy
Mahathi Thotakura
author_sort Naganarasimharaju Jukuri
collection DOAJ
description Introduction: The aetiology of ascites can be established in a majority of patients with routine clinical examination and conventional laboratory and imaging investigations; but in a minority, the cause may remain undetected even after these examinations. This ascites is termed as ascites of unknown origin. The Contrast Enhanced Computed Tomography (CECT) abdomen of these patients sometimes shows peritoneal nodules which can be useful to establish diagnosis. Aim: To evaluate the diagnostic value of peritoneal nodules detected on CECT abdomen in the management of ascites of unknown origin. Materials and Methods: This retrospective study was conducted in Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India on the data retrieved from the medical records of the patients between January 2019 to January 2021. These patients had already been vainly investigated with basic clinical, laboratory and diagnostic ultrasound examinations for the aetiology of ascites. All the patients who were diagnosed to have peritoneal nodules on CECT abdomen and later underwent laparoscopic tissue diagnosis of these peritoneal nodules were included in the study. The sizes of the peritoneal nodules and the distribution of the pathology were collected from CECT abdomen reports and compared them with the histopathology findings. Statistical analysis and plotting of the Receiver Operating Characteristic (ROC) curve were done using Statistical Package for the Social Sciences (SPSS) version 25.0. Results: Fifty-two patients of ascites of unknown origin with peritoneal nodules were included in the study. Of the total, 36 (69.2%) patients were males and 16 (30.8%) were females. Mean age of the patients was 48 years (22 to 74 years). Tissue diagnosis of the peritoneal nodules revealed that majority of the patients had carcinomatosis peritonei (88.5%) while a minority had tuberculosis (11.5%). A nodule size of more than 5 mm as a sign of malignancy on CECT abdomen had a sensitivity of 93% and a specificity of 83%. Based on the tissue diagnosis of the peritoneal nodules these patients were treated with antituberculosis drugs for tuberculous abdomen and chemotherapy for carcinomatosis peritonei. Conclusion: Detection of peritoneal nodules on CECT abdomen can be helpful in guiding the clinician for further management of ascites of unknown origin.
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spelling doaj.art-bad77e7b5970439696b9f0fee302aad02022-12-22T00:03:05ZengJCDR Research and Publications Pvt. Ltd.International Journal of Anatomy Radiology and Surgery2277-85432455-68742022-01-011101050810.7860/IJARS/2022/49607.2726Diagnostic Value of Peritoneal Nodules Detected on CECT Abdomen in Management of Ascites of Unknown Origin- A Retrospective StudyNaganarasimharaju Jukuri0Ramakrishna Narra1Mary Varunya Jehendran2Yeruva Yeshwanth Reddy3Mahathi Thotakura4Associate Professor, Department of Radiology and Medical Imaging, Katuri Medical College, Guntur, Andhra Pradesh, India.Professor, Department of Radiology and Medical Imaging, Katuri Medical College, Guntur, Andhra Pradesh, IndiaAssistant Professor, Department of Radiology, Vydehi Institute of Medical Sciences and Research Center, Bangalore, Karnataka, IndiaProfessor, Department of General Surgery, Katuri Medical College, Guntur, Andhra Pradesh, IndiaAssociate Professor, Department of Pathology, Katuri Medical College, Guntur, Andhra Pradesh, India.Introduction: The aetiology of ascites can be established in a majority of patients with routine clinical examination and conventional laboratory and imaging investigations; but in a minority, the cause may remain undetected even after these examinations. This ascites is termed as ascites of unknown origin. The Contrast Enhanced Computed Tomography (CECT) abdomen of these patients sometimes shows peritoneal nodules which can be useful to establish diagnosis. Aim: To evaluate the diagnostic value of peritoneal nodules detected on CECT abdomen in the management of ascites of unknown origin. Materials and Methods: This retrospective study was conducted in Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India on the data retrieved from the medical records of the patients between January 2019 to January 2021. These patients had already been vainly investigated with basic clinical, laboratory and diagnostic ultrasound examinations for the aetiology of ascites. All the patients who were diagnosed to have peritoneal nodules on CECT abdomen and later underwent laparoscopic tissue diagnosis of these peritoneal nodules were included in the study. The sizes of the peritoneal nodules and the distribution of the pathology were collected from CECT abdomen reports and compared them with the histopathology findings. Statistical analysis and plotting of the Receiver Operating Characteristic (ROC) curve were done using Statistical Package for the Social Sciences (SPSS) version 25.0. Results: Fifty-two patients of ascites of unknown origin with peritoneal nodules were included in the study. Of the total, 36 (69.2%) patients were males and 16 (30.8%) were females. Mean age of the patients was 48 years (22 to 74 years). Tissue diagnosis of the peritoneal nodules revealed that majority of the patients had carcinomatosis peritonei (88.5%) while a minority had tuberculosis (11.5%). A nodule size of more than 5 mm as a sign of malignancy on CECT abdomen had a sensitivity of 93% and a specificity of 83%. Based on the tissue diagnosis of the peritoneal nodules these patients were treated with antituberculosis drugs for tuberculous abdomen and chemotherapy for carcinomatosis peritonei. Conclusion: Detection of peritoneal nodules on CECT abdomen can be helpful in guiding the clinician for further management of ascites of unknown origin.https://www.ijars.net/articles/PDF/2726/49607_CE[Ra1]_F(SHU)_PF1(JY_SHU)_PFA(KM)_PN(SHU).pdfabdominal tuberculosiscontrast enhanced computed tomographydiagnostic laparoscopyperitoneal nodule sizeperitoneal thickening
spellingShingle Naganarasimharaju Jukuri
Ramakrishna Narra
Mary Varunya Jehendran
Yeruva Yeshwanth Reddy
Mahathi Thotakura
Diagnostic Value of Peritoneal Nodules Detected on CECT Abdomen in Management of Ascites of Unknown Origin- A Retrospective Study
International Journal of Anatomy Radiology and Surgery
abdominal tuberculosis
contrast enhanced computed tomography
diagnostic laparoscopy
peritoneal nodule size
peritoneal thickening
title Diagnostic Value of Peritoneal Nodules Detected on CECT Abdomen in Management of Ascites of Unknown Origin- A Retrospective Study
title_full Diagnostic Value of Peritoneal Nodules Detected on CECT Abdomen in Management of Ascites of Unknown Origin- A Retrospective Study
title_fullStr Diagnostic Value of Peritoneal Nodules Detected on CECT Abdomen in Management of Ascites of Unknown Origin- A Retrospective Study
title_full_unstemmed Diagnostic Value of Peritoneal Nodules Detected on CECT Abdomen in Management of Ascites of Unknown Origin- A Retrospective Study
title_short Diagnostic Value of Peritoneal Nodules Detected on CECT Abdomen in Management of Ascites of Unknown Origin- A Retrospective Study
title_sort diagnostic value of peritoneal nodules detected on cect abdomen in management of ascites of unknown origin a retrospective study
topic abdominal tuberculosis
contrast enhanced computed tomography
diagnostic laparoscopy
peritoneal nodule size
peritoneal thickening
url https://www.ijars.net/articles/PDF/2726/49607_CE[Ra1]_F(SHU)_PF1(JY_SHU)_PFA(KM)_PN(SHU).pdf
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