Objective: To assess the sensitivity, specificity, and predictive value of ultrasonography in surgical patients in abdominal emergency in regard to the indication for immediate operation, delayed abdominal exploration, or conservative treatment.
Design: A retrospective study was conducted after consecutive sampling of 98 patients in a control trial.
Setting: The study was conducted at the University Hospital of Catania (Italy), which serves as a general community hospital.
Patients: All patients with acute upper abdominal pain or blunt abdominal trauma were eligible for the study. A total of 110 patients were observed from 1990 to 1994, after plain X-ray of the abdomen in 12 patient was diagnosed visceral perforation and they went for immediate operation. The remaining 98 patients were divided into two groups: acute upper abdominal pain (56 patients) and blunt abdominal trauma (42 patients).
Intervention: Ultrasonography in the emergency department.
Main outcome measures: Conservative or operative treatment based on ultrasonographic and clinical findings. RESULTS. Ultrasonography showed a sensitivity of 100%, a specificity of 52.6%, a positive predictive value of 100%, and a negative predictive value of 100% in regard to the indication for surgery in cases of surgical abdominal emergency.
Conclusion: Ultrasonography saves time and money, can be performed in the emergency department, shows high sensitivity and specificity, and is the method of first choice in the evaluation of blunt trauma.