Role of emergency physician–performed ultrasound in the differential diagnosis of abdominal pain

Abstract

Objectives: This prospective study was performed to evaluate the diagnostic accuracy of bedside point-of-care abdominal ultrasonography performed by emergency physician in patients with non-traumatic acute abdominal pain. Methods: The patients, who were admitted to emergency department due to abdominal pain, were included in this study. The emergency physician obtained a routine history, physical examination, blood draws, and ordered diagnostic imaging. After the initial clinical examinations, all the patients underwent ultrasonography for abdominal pathologies by emergency physician and radiologist, respectively. Point-of-care abdominal ultrasonography compared with abdominal ultrasonography performed by radiologist as the gold standard. Results: The study included 122 patients. Gallbladder and appendix pathologies were the most commonly detected in the abdominal ultrasonography. Compared with abdominal ultrasonography, point-of-care abdominal ultrasonography was found to have 89% sensitivity and 94% specificity in gallbladder pathologies; 91% sensitivity and 91% specificity in acute appendicitis; 79% sensitivity and 97% specificity in abdominal free fluid; 83% sensitivity and 96% specificity in ovarian pathologies. Compared to final diagnosis, preliminary diagnoses of emergency physicians were correct in 92 (75.4%) patients. Conclusion: This study showed that emergency physicians were successful in identifying abdominal organ pathologies with point-of-care abdominal ultrasonography after training.

Agreement of emergency physician-performed ultrasound versus RADiology-performed UltraSound for cholelithiasis or cholecystitis: a systematic review

“…[22] included patients according to the opinion of EUS operator. In the other studies [18–21], the selection of patients undergoing EUS was; however, not consecutive, which gave rise to a convenience sample. Katirci et al .…”

“…Katirci et al . [20] and Miller et al . [21] did not avoid inappropriate exclusions, as they, respectively, excluded patients who recently ate a meal and those with a normal laboratory test.…”

“…RADUS operators were mostly blinded to the EUS results, although this is not clearly specified in Kozaci et al . [20] and Sherkachi et al . [23].…”

“…Kozaci et al . [20] and Torres-Macho et al . [24]; however, considered gallbladder EUS as a subgroup.…”

“…Substantial agreement was found after article screening and eligibility assessment before consensus using Cohen's Kappa statistics (k = 0.8). Out of 39 articles evaluated in full, 7 studies [18][19][20][21][22][23][24] were included, with a total of 1061 patients undergoing EUS, with RADUS as the reference standard.…”