A REVIEW OF EVALUATION OF THE ACCURACY OF ULTRASOUND IN THE DETECTION OF HEPATITIS

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A REVIEW OF EVALUATION OF THE ACCURACY OF ULTRASOUND IN THE DETECTION OF HEPATITIS

ABSTRACT

Hepatitis is one of the commonest complaints in patients seeking medical advice, and in majority of the cases the etiology is simple and treatable. Ultrasonography is hazard free and cost effective investigation. This study was designed to evaluate the accuracy of ultrasound in the detection of hepatitis it is a fact that there is substantial improvement in advances made in imaging techniques especially towards most of the deadly diseases like hepatitis, yet one important question is “How accurate are such imaging modalities in detecting such abnormality. This research work was carried out to evaluate the accuracy of ultrasound in the defection of hepatitis. It went further to establish the age and sex distribution. It covered a wide range of patients who came for ultrasound scan on hepatitis at UNTH. The inherent problems associated with effective ultrasound utilization were also highlighted. The research methodology was designed in a manner that ensured adequate representation of the population needed for. The research. Convenience sanipling method was used in selecting patients who presented for ultrasound scan during the period of one year. The patients were either provisionally or ultrasonographically diagnosed to have hepatitic. The ultrasound and the provisionally findings were correlated with laboratory findings to determine whether such ultrasound finding is correct or not. In analyzing the data, descriptive models, percentage and statistical charts were used. The sensitivity and specificity of ultrasound in the detection of hepatitis were calculated to be 96.5% and 100% respectively. It was discovered that males were affected more than females within the period under study, 38% were reported dead while 62% survived the condition or were discharged alive. In furtherance of the research objectives, summary of the research findings and recommendation were made which when implemented, the researcher hopes will bring about high efficiency and effective utilization of ultrasound. The focus of recommendation was specifically on improving the accuracy of ultrasound in the detection of hepatitis. Finally based on the research findings, it was concluded that ultrasound is accurate in the detection of hepatitis.

CHAPTER ONE

INTRODUCTION

Patients presenting with hepatitis comprise the largest group of people reporting to medical and surgical out-patient department/OPDs. Following the history and clinical examination, ultrasonography has become one of the first and most useful methods of investigation1.

Hepatitis whether, acute or chronic, is caused by diseases of the liver, gall bladder, kidneys, pancreas, stomach, duodenum, spleen, pleura, pericardium and basal lung segments1,2. Rare causes include aortic aneurysm and acute myocardial infection. All these conditions have useful sonographic features which help in their diagnosis except uncomplicated peptic ulcer disease, acute myocardial infarction and based pnueumonitis1,2. The liver is the largest abdominal organ which weighs about 1.5kg and is located in the upper part of the abdomen predominantly on the right side. It has a complex structural organization which divides the lobules with enormous functional activities. All metabolic activities involve the liver and therefore the organ is the most frequently damaged organ in the whole body.

It is assumed that over five hundred separate activities occur within a single liver cell. These involve such broad categories as intermediary metabolism of carbohydrates, proteins and lipids. Synthesis of proteins such as fibrinogen, albumen, prothrombin and a host of enzymes, conjugation of bilirubin with glucuronide, detoxication and removal of foreign materials such as bacteria, drugs and other noxious substances, in addition to the above mentioned activities, storage of many substances such as proteins, glycogens, vitamins and minerals which including iron also takes place in the liver3.

All these enormous functional activities of the liver disposes of it to a number of pathological conditions which includes vascular disorders, metabolic, toxic, obstructive and neoplastic.

Different types of hepatitis exist under the major classifications: hepatitis A, and hepatitis B.

Hepatitis A includes those types that are caused by RNA virus which does not persist in the blood serum and can be transmitted by injection of infected food and water.

Hepatitis B is the type caused by DNA virus and it persist in the blood serum and can be transmitted by infected blood or by contaminated needles or others instruments.

It is important to emphasis that the functions of the liver may be impaired due to abnormality as a result of remarkable tolerance by the liver to inflamentation. It is well know that is is only when a greater part of the liver has being damaged that laboratory or x-ray show any abnormality4.

It then becomes necessary for ultrasound investigation. Ultrasound defects liver hepatitis weather A or B by demonstrating the stage at the time.

The researcher therefore wants to study and investigate how accurate ultrasound is in the defection of hepatitis. In a retrospective approach, he intends to determine how hepatitis are accurately detected by ultrasound in relation to provisional diagnosis and laboratory findings.

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