Impact of surgeon-performed ultrasound on diagnosis of abdominal pain.
BACKGROUND
A randomised study was performed to evaluate the diagnostic accuracy of surgeon-performed ultrasound in the emergency department for patients presenting with abdominal pain.


METHODS
Surgeons responsible for the examination of study patients underwent 4 weeks of ultrasound training. 800 patients who were attending the emergency department for abdominal pain were randomised to undergo or not undergo surgeon-performed ultrasound as a complement to standard examination. The preliminary diagnosis made by the surgeon, with or without ultrasound, was compared with the final diagnosis made by a senior surgeon 6-8 weeks later.


RESULTS
Diagnostic accuracy was significantly higher in the group examined with ultrasound (64.7% vs 56.8%, p = 0.027). Ultrasound proved to be helpful in making or confirming a correct diagnosis in 24.1% of cases receiving ultrasound and to contribute in 2.9%. In 22.3% of patients the diagnosis of non-specific pain was confirmed by normal findings. Ultrasound was misleading in 10.2% of cases and had no influence on the diagnosis in 40.0%.


CONCLUSIONS
For patients with acute abdominal pain, higher diagnostic accuracy is achieved when surgeons use ultrasound as a diagnostic complement to standard examination. The use of bedside ultrasound should be considered in emergency departments.
Lindelius
A
A
Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden. anna.lindelius@sodersjukhuset.se
Törngren
S
S
Sondén
A
A
Pettersson
H
H
Adami
J
J
D015746:Abdominal Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002983:Clinical Competence / Q000592:standards*; D004503:Education, Medical, Graduate; D004636:Emergency Service, Hospital / Q000592:standards; D005260:Female; D013502:General Surgery / Q000193:education / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000592:standards; D014463:Ultrasonography