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
Results
There were 585 (10%) US exams requested from ED physicians for patients without clear pretest suspicion.
Of these,
447 (76%) had negative findings on US while in 138 patients (24%) US detected pathologies related to abdominal pain.
After initial US examination 76/585 patients (13%) underwent abdominal CT: 39 patients with negative and 37 patients with positive previous US findings.
According to clinical examination and laboratory tests 39 patients with negative US findings underwent CT,
which confirmed negativity in 13 (true negative,
TN) and detected the cause of pain in 26 (false negative,
FN) cases (Fig.
2-3),
mostly related to gastrointestinal tract diseases.
In the group of patients with positive US there was concordance with additional CT in 36/37 (true positive,
TP) (Fig.
4-5); in 1 case CT scan was normal (false positive,
FP) while US identified a small amount of fluid in the rectouterine pouch.
Positive predictive value of the US in this specific context resulted 97%,
while the negative predictive value was 33% (Table 2).
Regardless of the positive or negative US result,
comparing the US with the CT report,
there was concordance in 49/76 (64.5%) patients.