rss
Emerg Med J 2008;25:486-491 doi:10.1136/emj.2007.052142
  • Original Article

Impact of surgeon-performed ultrasound on diagnosis of abdominal pain

This article has been Unlocked
  1. A Lindelius1,2,
  2. S Törngren1,2,
  3. A Sondén1,2,
  4. H Pettersson1,
  5. J Adami3
  1. 1
    Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
  2. 2
    Department of Surgery, Stockholm South General Hospital, Stockholm, Sweden
  3. 3
    Karolinska Institutet, Department of Medicine, Clinical Epidemiology Unit, Stockholm, Sweden
  1. Dr A Lindelius, Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Department of Surgery, Stockholm South General Hospital, Sjukhusbacken 10, 118 83 Stockholm, Sweden; anna.lindelius{at}sodersjukhuset.se
  • Accepted 8 January 2008

Abstract

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%.

Conclusion: 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.

Footnotes

  • Competing interests: None.

  • Funding: The study was conducted with funding from the County Council of Stockholm.

  • Ethics approval: The study was approved by the Institutional Review Board at Karolinska Institutet, Stockholm, Sweden.

This article has been Unlocked

This Article

  1. Abstract
  2. Full text
  3. PDF

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.