Keywords:
Emergency, Abdomen, Gastrointestinal tract, Ultrasound, CT, Diagnostic procedure
Authors:
A. Vizzuso, D. Ribuffo, F. Pellegrino, Z. Ferrante, S. Tartari, M. Giganti, G. Benea; Ferrara/IT
DOI:
10.1594/ecr2018/C-2373
Methods and materials
From a total of 5847 patients with non-traumatic acute abdominal pain admitted to ED in 2016 who underwent US as first-line examination,
we retrospectively selected the ones sent to Emergency Radiology with undetermined clinical impression,
analyzing diagnostic pathway and discharge diagnosis (Fig.
1).For all patients we assessed the diagnostic issue and the clinical framework (present and past medical history,
physical examination and laboratory tests).In our research,
we rejected all patients with a clear issue and clinical guidelines,
whereas we included patients with diffuse abdominal pain with undetermined clinical impression and no specific diagnostic suspicion.
Of these patients we examined ultrasound report and diagnosis,
distinguishing patients who successively underwent CT examination of each patient in order to check how many of these patients were positive to abdominal US and among these,
which and how many pathologies had been identified (Table 1).
The next step was to identify patients who performed an abdominal CT scan,
within a maximum of two weeks from the US.Later,
considering CT as diagnostic gold standard,
we compared US findings with CT diagnosis,
in order to assess the concordance between US and CT report.
Diagnostic accuracy of abdominal US in this setting was calculated and in particular the ability of the US to recognize abdominal pathologies causing acute abdominal pain compared to CT.