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.