Ultrasound scans done by surgeons for patients with acute abdominal pain: a prospective study

Abstract

Objective: To evaluate the routine use of abdominal ultrasonography (US) in patients admitted to the surgical emergency unit with acute abdominal pain.

Design: Prospective study with a three-step evaluation of patients over a 12-month period.

Setting: University hospital, Switzerland.

Subjects: 496 patients (male/female = 234/262; mean age 45 years) who presented with acute abdominal pain.

Interventions: Every patient underwent routine investigations and had an abdominal US by the attending surgeon.

Main outcome measures: Clinical diagnosis, post-ultrasonography diagnosis and final diagnosis.

Results: US improved the correct diagnostic rate from 348 (70%) to 414 (83%). The diagnostic accuracy for acute appendicitis and biliary tract disease improved after US from 455 (92%) to 488 (98%) and from 463 (93%) to 490 (99%), respectively; the corresponding sensitivities and specificities were 91% and 99% and 94% and 99%.

Conclusions: Ultrasonography should be part of routine surgical investigation and should be mastered and used by surgeons.