Ultrasound evaluation of acute abdominal pain in the emergency department

: In a retrospective study the value of sonography in the diagnosis of acute traumatic and nontraumatic conditions was evaluated. Records of patients who underwent emergency sonography during 1989 (group A, 159 patients) and 1991 (group B, 415 patients) were reviewed. In nontraumatic cases sonography confirmed the preliminary diagnosis in 43% and 50% of patients in groups A and B, respectively. In cases of acute abdominal pain with fever or leukocytosis, but without initial specific diagnosis, biliary disease was diagnosed in 3 group B patients; in a group A patient an abdominal aortic aneurysm was detected. There were positive sonographic findings in 42% and 17% of cases of blunt abdominal trauma in groups A and B, respectively. Sonographic evaluation of suspected splenic trauma confirmed the diagnosis in only 2 out of 9 patients in group B. Both studies show that sonography is a very effective, complementary, noninvasive method for evaluating patients with suspected acute surgical conditions. Sonography significantly reduced misdiagnosed biliary disease in cases of abdominal pain with fever or leukocytosis. In trauma, sonography obviated invasive diagnostic and surgical interventions in a significant number of cases. We recommend routine sonography in evaluating suspected, acute surgical conditions of traumatic or nontraumatic nature and in cases of undiagnosed abdominal pain with fever or leukocytosis.