Accuracy of viscera slide detection of abdominal wall adhesions by ultrasound.
Viscera slide is the normal, longitudinal movement of the intraabdominal viscera caused by respiratory excursions of the diaphragm. By detecting areas of restricted viscera slide, ultrasonic imaging was used to identify anterior abdominal wall adhesions prior to laparotomy or laparoscopy. Transcutaneous ultrasound examination was performed on 110 patients. A prediction of adhesions was made for each patient and then compared to the findings during subsequent laparotomy or laparoscopy. Only patients with previous abdominal surgery or history of peritonitis demonstrated adhesions. Sensitivity and specificity of viscera slide ultrasound in predicting adhesions were 90% and 92%. Nine out of 10 false results involved misinterpretation of ultrasound images of the lower one-third of the abdomen. Ultrasonic imaging of viscera slide is highly accurate in detecting abdominal wall adhesions. This technique is most useful in guiding the insertion of trocar in laparoscopic surgery, and as a noninvasive method in studying the formation of adhesions.
Kolecki
R V
RV
Department of Surgery, Medical College of Pennsylvania, Philadelphia 19129.
Golub
R M
RM
Sigel
B
B
Machi
J
J
Kitamura
H
H
Hosokawa
T
T
Justin
J
J
Schwartz
J
J
Zaren
H A
HA
D000009:Abdominal Muscles / Q000000981:diagnostic imaging* / Q000601:surgery; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D010535:Laparoscopy; D010538:Peritonitis / Q000150:complications; D011183:Postoperative Complications / Q000209:etiology; D011237:Predictive Value of Tests; D011300:Preoperative Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000267:Tissue Adhesions / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D014463:Ultrasonography; D014781:Viscera / Q000000981:diagnostic imaging* / Q000601:surgery