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Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 1994 Jul;76(4):228–233.

Ultrasound scanning of the acute abdomen by surgeons in training.

R J Williams 1, A C Windsor 1, R D Rosin 1, D V Mann 1, M Crofton 1
PMCID: PMC2502236  PMID: 8074382

Abstract

Ultrasound is widely used in the investigation of abdominal symptoms. Its increasing popularity may lead to pressure on radiological services, diagnostic delay and prolonged hospital stay. Immediate imaging performed by radiologists can contribute useful information in acute emergencies. This study assessed the accuracy and value of abdominal ultrasonography when carried out by admitting surgeons. Three surgical registrars were first instructed for two half days by a consultant radiologist. Patients with acute symptoms were scanned at the time of initial presentation using an Aloka SSD-620 scanner with 3.5 and 5 MHz probes. A total of 205 scans was performed--124 of the upper and 81 of the lower abdomen. Immediate ultrasound provided information that contributed to the establishment or refutal of a diagnosis in 138 patients (67.3%), predominantly by confirming or excluding hepatobiliary disease, tubo-ovarian pathology or aortic aneurysms and in blunt abdominal trauma. The diagnosis was altered in a small proportion (7.8%). Scanning proved unhelpful in 62 patients and misleading in five. Findings concurred with those of a radiologist in 86% of the 139 patients subsequently scanned. Abdominal ultrasound is a useful tool in the hands of surgeons dealing with emergencies and may occasionally provide vital information. If access to radiological facilities is delayed, ultrasound by the admitting surgeon could lead to improved patient management and cost savings.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams D. H., Fine C., Brooks D. C. High-resolution real-time ultrasonography. A new tool in the diagnosis of acute appendicitis. Am J Surg. 1988 Jan;155(1):93–97. doi: 10.1016/s0002-9610(88)80264-2. [DOI] [PubMed] [Google Scholar]
  2. Fa E. M., Cronan J. J. Compression ultrasonography as an aid in the differential diagnosis of appendicitis. Surg Gynecol Obstet. 1989 Oct;169(4):290–298. [PubMed] [Google Scholar]
  3. Fuentes R., Sosa M., Martínez F., Rodríguez M. New ultrasonic finding in perforated ulcer. Lancet. 1991 Mar 23;337(8743):733–733. doi: 10.1016/0140-6736(91)90316-h. [DOI] [PubMed] [Google Scholar]
  4. Gai H. Acute abdominal pain. Actual surgical aspects of sonography. Surg Endosc. 1988;2(1):28–35. doi: 10.1007/BF00591395. [DOI] [PubMed] [Google Scholar]
  5. Griffiths C. Ultrasound and laparoscopy in surgery. Br J Hosp Med. 1989 Sep;42(3):173–173. [PubMed] [Google Scholar]
  6. Jehle D., Davis E., Evans T., Harchelroad F., Martin M., Zaiser K., Lucid J. Emergency department sonography by emergency physicians. Am J Emerg Med. 1989 Nov;7(6):605–611. doi: 10.1016/0735-6757(89)90283-0. [DOI] [PubMed] [Google Scholar]
  7. Jones P. F. Practicalities in the management of the acute abdomen. Br J Surg. 1990 Apr;77(4):365–367. doi: 10.1002/bjs.1800770404. [DOI] [PubMed] [Google Scholar]
  8. Kang W. M., Lee C. H., Chou Y. H., Lin H. J., Lo H. C., Hu S. C., P'eng F. K. A clinical evaluation of ultrasonography in the diagnosis of acute appendicitis. Surgery. 1989 Feb;105(2 Pt 1):154–159. [PubMed] [Google Scholar]
  9. Kuuliala I. K., Niemi L. K. Sonography as an adjunct to plain film in the evaluation of acute abdominal pain. Ann Clin Res. 1987;19(5):355–358. [PubMed] [Google Scholar]
  10. McGrath F. P., Keeling F. The role of early sonography in the management of the acute abdomen. Clin Radiol. 1991 Sep;44(3):172–174. doi: 10.1016/s0009-9260(05)80862-1. [DOI] [PubMed] [Google Scholar]
  11. Parys B. T., Barr H., Chantarasak N. D., Eyes B. E., Wu A. V. Use of ultrasound scan as a bedside diagnostic aid. Br J Surg. 1987 Jul;74(7):611–612. doi: 10.1002/bjs.1800740724. [DOI] [PubMed] [Google Scholar]
  12. Paterson-Brown S., Eckersley J. R., Sim A. J., Dudley H. A. Laparoscopy as an adjunct to decision making in the 'acute abdomen'. Br J Surg. 1986 Dec;73(12):1022–1024. doi: 10.1002/bjs.1800731230. [DOI] [PubMed] [Google Scholar]
  13. Puylaert J. B., Rutgers P. H., Lalisang R. I., de Vries B. C., van der Werf S. D., Dörr J. P., Blok R. A. A prospective study of ultrasonography in the diagnosis of appendicitis. N Engl J Med. 1987 Sep 10;317(11):666–669. doi: 10.1056/NEJM198709103171103. [DOI] [PubMed] [Google Scholar]
  14. Puylaert J. B., Vermeijden R. J., van der Werf S. D., Doornbos L., Koumans R. K. Incidence and sonographic diagnosis of bacterial ileocaecitis masquerading as appendicitis. Lancet. 1989 Jul 8;2(8654):84–86. doi: 10.1016/s0140-6736(89)90322-x. [DOI] [PubMed] [Google Scholar]
  15. Schwerk W. B., Wichtrup B., Rüschoff J., Rothmund M. Acute and perforated appendicitis: current experience with ultrasound-aided diagnosis. World J Surg. 1990 Mar-Apr;14(2):271–276. doi: 10.1007/BF01664891. [DOI] [PubMed] [Google Scholar]
  16. Sim K. T., Picone S., Crade M., Sweeney J. P. Ultrasound with graded compression in the evaluation of acute appendicitis. J Natl Med Assoc. 1989 Sep;81(9):954–957. [PMC free article] [PubMed] [Google Scholar]
  17. Simeone J. F., Novelline R. A., Ferrucci J. T., Jr, DeLuca S. A., McCabe C. J., Mueller P. R., Hall D. A., Wittenberg J., Butch R. J., Papanicolaou N. Comparison of sonography and plain films in evaluation of the acute abdomen. AJR Am J Roentgenol. 1985 Jan;144(1):49–52. doi: 10.2214/ajr.144.1.49. [DOI] [PubMed] [Google Scholar]
  18. Thal E. R., Meyer D. M. The evaluation of blunt abdominal trauma: computed tomography scan, lavage, or sonography? Adv Surg. 1991;24:201–228. [PubMed] [Google Scholar]
  19. Walsh P. F., Crawford D., Crossling F. T., Sutherland G. R., Negrette J. J., Shand J. The value of immediate ultrasound in acute abdominal conditions: a critical appraisal. Clin Radiol. 1990 Jul;42(1):47–49. doi: 10.1016/s0009-9260(05)81622-8. [DOI] [PubMed] [Google Scholar]
  20. Weiler S., Rohmer P., Coche G., Weill F. L'échographie dans l'urgence abdominale. Résultats d'une série de 179 observations. J Radiol. 1986 Nov;67(11):765–768. [PubMed] [Google Scholar]
  21. Zielke A., Malewski U., Lindlar R., Förster R., Klotter H. J., Rüschoff J., Sitter H., Rothmund M. Sonographie bei Verdacht auf akute Appendicitis: Möglichkeit oder Notwendigkeit für den Chirurgen? Chirurg. 1991 Oct;62(10):743–749. [PubMed] [Google Scholar]

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