The therapeutic impact of abdominal ultrasound in patients with acute abdominal symptoms.
OBJECTIVE
The technical performance of abdominal ultrasound in the investigation of acute abdominal pain has been thoroughly investigated but its therapeutic effects are less well understood. We aimed to determine the therapeutic effect of abdominal ultrasound in the investigation of acute abdominal pain.


METHODS
A pre- and post-intervention observational study design was used to determine the diagnostic and therapeutic effects of abdominal ultrasound for acute abdominal pain. Referring clinicians completed a pre-ultrasound questionnaire that detailed their leading diagnosis, confidence in this and intended management in 100 consecutive adult patients. Following ultrasound a second questionnaire was completed. This again detailed the leading diagnosis, confidence in this and their intended management. Clinicians quantified the management contribution of ultrasound both for the individual case in question and in their clinical experience generally.


RESULTS
The leading diagnosis was either confirmed or rejected in 72 patients and a new diagnosis provided where no prior differential diagnosis existed in 10. Diagnostic confidence increased significantly following ultrasound (mean score 6.5 pre-ultrasound vs 7.6 post-ultrasound, P < 0.001). Intended management changed following ultrasound in 22 patients; 15 intended laparotomies were halted and a further seven patients underwent surgery where this was not originally intended. Ultrasound was rated either 'very' or 'moderately' helpful in 87% of patients, with 99% of clinicians finding it either 'very' or 'moderately' helpful generally.


CONCLUSIONS
Abdominal ultrasound has considerable diagnostic and therapeutic effect in the setting of acute abdominal pain.
Dhillon
S
S
Department of Radiology, Northwick Park and St Mark's Hospitals, Harrow, UK.
Halligan
S
S
Goh
V
V
Matravers
P
P
Chambers
A
A
Remedios
D
D
D000006:Abdomen, Acute / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003657:Decision Making; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D014464:Ultrasonic Therapy / Q000379:methods; D014463:Ultrasonography