SENSITIVITY OF ULTRASONOGRAPHY IN THE EARLY DIAGNOSIS OF CHOLELITHIASIS AMONG PATIENTS AGED 20–40 YEARS: A CROSS-SECTIONAL STUDY IN DERA ISMAIL KHAN, PAKISTAN

Abstract

Background: Gallbladder stone disease (cholelithiasis) is a common hepatobiliary disorder that may remain asymptomatic in early stages but can progress to severe complications if not treated promptly. Ultrasonography is widely used as the first-line imaging modality due to its safety, affordability, and accessibility; however, its diagnostic performance in early disease detection among young adults’ remains insufficiently explored in resource-limited settings. Objective: To assess the sensitivity and diagnostic accuracy of ultrasonography in the early detection of gallbladder stones among patients aged 20–40 years in Dera Ismail Khan, Pakistan.  Research Methodology: A hospital-based cross-sectional study was conducted on 400 symptomatic patients aged 20–40 years using consecutive sampling. All patients underwent abdominal ultrasonography, and findings were compared with a reference standard (surgical findings, MRCP, or clinical follow-up). Data were analyzed using SPSS version 25. Diagnostic accuracy measures including sensitivity, specificity, PPV, NPV, and overall accuracy were calculated. Inferential statistics included independent sample t-test and one-way ANOVA to evaluate the effect of BMI and age on diagnostic performance. Results and findings: Out of 400 patients, 185 (46.3%) were confirmed to have gallstones. Ultrasonography identified 170 true positives, 185 true negatives, 30 false positives, and 15 false negatives. The diagnostic performance showed sensitivity of 91.9%, specificity of 86.0%, positive predictive value of 85.0%, negative predictive value of 92.5%, and an overall diagnostic accuracy of 88.8%. Independent sample t-test revealed a significant difference in diagnostic accuracy between BMI groups (t = 5.42, p < 0.001), with reduced accuracy in overweight/obese patients. One-way ANOVA showed a significant variation in sensitivity across age groups (F = 7.12, p < 0.001), with higher sensitivity observed in older age groups (up to 94%). Conclusion and Implication: Ultrasonography demonstrates high sensitivity and strong diagnostic accuracy for gallbladder stone detection in young adults. However, its performance is significantly influenced by BMI and age. Despite these limitations, it remains the most effective and accessible first-line diagnostic tool in resource-limited clinical settings.

Keywords: Gallstones, Ultrasonography, Sensitivity, Diagnostic Accuracy, Cross-sectional study, Cholelithiasis, Pakistan