 Good morning everyone. I am Dr. K. Rohini Reddy, finally a resident at Chelmer Anandrov Institute of Medical Sciences, Kareem Nagar. Today I am going to present about role of computer tomography in evaluation of non-traumatic acute abdomen. Acute abdominal pain is most common causes of emergency. Spectrum of causes range from benign self-limiting conditions to life-threatening disorders. Hence a timely and accurate diagnosis is needed to intervene at appropriate time to reduce morbidity and mortality. Stominal radiograph is widely available and useful in patient's bowel obstruction pneumoperitonium. However, specific diagnosis couldn't be made out. Ultrasonography is another widely used imaging modality. Computed tomography is most appropriate imaging modality in arriving at specific diagnosis. CT has achieved this vital role and permits global visualization of gut, miscellany, momentum, peritonium, retroperitonium, vasculature, solid organs, abdominal musculature and bones. Aims and objectives of this study to evaluate accuracy of CT in diagnosis of non-traumatic acute abdomen to evaluate impact of CT in early diagnosis on management to enumerate spectrum of causes of non-traumatic acute abdomen. Materials and methods. Source of data is collected from 40 patients presenting the symptoms. Sample size 40 cases. Study is conducted on Siemens 16 slice computer tomography. Inclusion criteria. History of acute abdominal pain, abdominal distention, abdominal rigidity. Exclusion criteria. History of trauma. Pregnant ladies. Study protocol. Application of contrast agent. Contrast application is adjusted based upon the provisional diagnosis. Oral intravenous rectal contrast will be given in inconclusive cases. Exceptions for oral contrast are high-degree bowel obstruction, acute bleed, acute pancreatitis. In severe cases, oral contrast transit time 60 minutes may not be possible. In such cases, oral contrast is avoided. CT technique. Patient is in supine position with arms raised above the head and abdomen is centered within the gallery. Initially, non-enhanced CT will be taken from level of diaphragm through symphysis pubis. Then 1 to 2 ml per kg of water soluble non-ionic intravenous contrast will be given at the rate of 4 ml per second through a power injector. Then post-contrast arterial venous and elate phases will be taken at 25 seconds, 45 seconds and 10 minutes respectively. In necessary cases, oral contrast will be given an hour prior to the procedure. Observation and results. Age-wise distribution. 11 cases are seen in less than 30 years age group. 20 cases are seen in 30 to 60 years age group. And 9 cases are seen in more than 60 years age group. Gender distribution. Male preponderance is seen. Organ specific findings. Diseases pertain to organ specific or depicted within the graph. And diseases pertaining to bowel are highest. Distribution of diseases pertaining to bowel. Acute appendicitis is most frequently encountered and it most commonly observed surgical emergency in our study. Depicting the change in the surgical management after the CT. In late patients, surgery was planned before performance of CT. After CT was performed, there is a change in the diagnosis. And these patients were put on the conservative management. Depicting the change in the conservative management. In 5 patients who were planned to be manager conservatively before the CT. There was a change in the diagnosis after the CT. And these were posted to the surgery immediately. Case 1. A 32 year old male patient present with right lower quadrant pain fever wanting for 3 days. CECT findings are appendix is inflamed and thickened. And maximum diameter measuring 12 mm in size. Periapendicular fast training noted no obvious mass and abscess formation a case of acute appendicitis. Case 2. Findings are loculated collection with irregular enhancing walls noted in right iliac fossa case of appendicular abscess. Case 3. Findings are pericolonic oval shaped lesion with fat attenuation with periapendigial fast training with surrounding hyper densoring which represent peritoneal thickening. Central high attenuation dot represent thrombosis vessel a case of epiproic appendicitis. Case 4. A distinction of miscantry along with bowel loops with proximal dilatation of stomach and small bowel loops in the superior miscantry Cartian bean axis is altered a case of midgirt volvulus. Case 5. Findings are dilated bowel loops up to the distal ilium with multiple air flu levels. Coloric bowel loops appear collapsed. Transition zone was senior terminal ilium a case of small bowel obstruction. Case 6. Findings are pancreas is enlarged in size necrotic areas noted within the pancreas. There is a necrotic collection in the peripantreatic region with thickening of xerophage and lateral cornel fascia a case of acute necrotizing pancreatitis. Case 7. Findings are agile and coronal imager shows calculus of size 7 mm in left distal urator showing upstream dilatation of ipsilateral pelvic calcium system and urator. A case of left distal urator calculus with hydrourator nephrosis. Case 8. 34 year old female patient findings are heliocolic and helioelial inter-susception noted. Case 9. Findings are non-contrast computer tomography shows hypodense lesion in the right robe of liver and CECT shows peripheral rim enhancement a case of liver access. Case 10. Findings on coronal and axial imagers of sigmoid volvulus with intestinal obstruction shows diffuse dilatation of large bowel loops with a transition zone in the form of twisting of sigmoid miscantry a case of sigmoid volvulus. Case 11. Findings are free intraperitoneal air with focal discontinuity in anterior wall of first part of biodenum suggestive of perforation. Case 12. Findings agile image a shows dilatation of distal vaginal and proximal ilial loops and image b shows large obstructed right inguinal honeya with bowel loops as its content with minimal free peritoneal fluid. Case 13. Findings are few small diverticulum is noted in the distal part of the descending column with surrounding miscented fast running suggestive of diverticulitis. Case 14. Discussion. In our study, CT was found to be better than ultrasonography in finalizing the diagnosis and impact of CT on management of the patients was as such. In 8 patients surgery was planned before performance of CT after CT there was change in diagnosis and they were put on the conservative management. Similarly, in the 5 patients who were planned to be managed conservatively after CT was performed there was a change in the final diagnosis and surgery was performed. Among the total 4 cases of acute appendicitis ultrason to diagnose only 2 cases but CT could diagnose additional 2 cases. Appendix when especially in retrocecal in position is difficult to visualize because of fecal gas shadow. So these cases and early acute appendicitis and its complications are better detected on the computer tomography. Hollow viscous perforation case is better detected on CT. Volubilus will be better detected on CT. CT is superior in diagnosing acute pancreatitis and its complications in ultrasonography is difficult to diagnose pancreatitis because of bobel gas and obesity. And complications of pancreatitis are better detected on the CT. Euretic calcula is better detected in CT and it can detect exact location, size and severity of obstruction. Vascular pathologies like SMH thrombus, SMV thrombus, etc. can be better detected on CT. Similarly 40 cases in our study were followed up and correct diagnosis was obtained in 39 cases. In our study CT provided a false positive diagnosis in only one patient. The disadvantage of CT is cost and radiation exposure but CT provides a timely diagnosis and reduces hospital stay and mobility. Conclusion, in our study it has been proved that CT helps in arriving at an accurate diagnosis. Associated complications can be determined with CT. CT can effectively guide the clinician regarding the management. It helps to determine who needs surgery and who do not. Hence CT can be considered as primary imaging modality in non-traumatic acute abdomen. Despite the small risk of radiation and slightly increased cost prompt utilization of CT in investigating the cases of non-traumatic acute abdomen use, more accurate diagnosis and leads a better decision making, redundant management and helps improving the outcome. These are all the references. Thank you.