Diagnostic accuracy of ultrasound and computed tomography in obstructive jaundice at emergency department: a retrospective study

Obstructive jaundice is a common clinical condition, often requiring timely diagnosis to guide management. This study aimed to evaluate the diagnostic performance of ultrasound (USG) and computed tomography (CT) compared to endoscopic retrograde cholangiopancreatography (ERCP) as a reference standard in the emergency department. A retrospective cross-sectional study was conducted at Ankara Bilkent City Hospital Emergency Department from January 2022 to December 2023. Data were collected from 1011 patients who underwent ERCP and met inclusion criteria. Diagnostic accuracy of USG and CT for choledocholithiasis, biliary strictures, malignancies, and ductal dilatation was assessed. USG showed low sensitivity (20.83%) but high specificity (85.96%) for choledocholithiasis, while CT demonstrated higher sensitivity (57.55%) and similar specificity (80.93%). CT consistently outperformed USG in sensitivity across diagnoses, whereas USG maintained higher specificity. USGs ease of use and non-invasive nature support its role as the first-line imaging, though negative findings should prompt further CT evaluation. USG and CT remain essential tools in the diagnostic evaluation of obstructive jaundice in the emergency department. While USG offers high specificity and initial assessment capability, CT provides superior sensitivity and is recommended when USG findings are negative but clinical suspicion remains.