title: Point of Care Ultrasound Accurately Distinguishes Inflammatory from Noninflammatory Disease in Patients Presenting with Abdominal Pain and Diarrhea.
abstract: Background. Approaches to distinguish inflammatory bowel disease (IBD) from noninflammatory disease that are noninvasive, accurate, and readily available are desirable. Such approaches may decrease time to diagnosis and better utilize limited endoscopic resources. The aim of this study was to evaluate the diagnostic accuracy for gastroenterologist performed point of care ultrasound (POCUS) in the detection of luminal inflammation relative to gold standard ileocolonoscopy. Methods. A prospective, single-center study was conducted on convenience sample of patients presenting with symptoms of diarrhea and/or abdominal pain. Patients were offered POCUS prior to having ileocolonoscopy. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with 95% confidence intervals (CI), as well as likelihood ratios, were calculated. Results. Fifty-eight patients were included in this study. The overall sensitivity, specificity, PPV, and NPV were 80%, 97.8%, 88.9%, and 95.7%, respectively, with positive and negative likelihood ratios (LR) of 36.8 and 0.20. Conclusion. POCUS can accurately be performed at the bedside to detect transmural inflammation of the intestine. This noninvasive approach may serve to expedite diagnosis, improve allocation of endoscopic resources, and facilitate initiation of appropriate medical therapy.
authors.affiliation: Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada T2N 2T9.
authors.forename: Kerri L
authors.initials: KL
authors.lastname: Novak
authors.affiliation: Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada T2N 2T9.
authors.forename: Deepti
authors.initials: D
authors.lastname: Jacob
authors.affiliation: Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada T2N 2T9; Department of Community Health Sciences, Calgary, AB, Canada T2N 2T9.
authors.forename: Gilaad G
authors.initials: GG
authors.lastname: Kaplan
authors.affiliation: Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada T2N 2T9.
authors.forename: Emma
authors.initials: E
authors.lastname: Boyce
authors.affiliation: Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada T2N 2T9.
authors.forename: Subrata
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Division of General Internal Medicine, Calgary, AB, Canada T2N 2T9.
authors.forename: Irene
authors.initials: I
authors.lastname: Ma
authors.affiliation: Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada T2N 2T9.
authors.forename: Cathy
authors.initials: C
authors.lastname: Lu
authors.affiliation: Diagnostic Imaging, University of Calgary, Calgary, AB, Canada T2N 2T9.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Wilson
authors.affiliation: Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada T2N 2T9.
authors.forename: Remo
authors.initials: R
authors.lastname: Panaccione
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003967:Diarrhea / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult