Journal article Open Access

The Role of Pocus in the Diagnosis of Hollow Viscus Non-Traumatic Acute Abdomen

Svetlana Bezhanova; Assoc. Prof. Stoyanka Dineva; Petar Spasov; Assoc. Prof. Branimir Golemanov

Point-of-care ultrasound (POCUS) is a non-invasive diagnostic bedside imaging modality which is a fast, safe, accurate and valuable tool for diagnosing gastrointestinal pathology, clinical decision making in emergency situations within a very short time. The aim of the study was to assess the role and clinical effects of the initial Point-of-Care ultrasound (POCUS) evaluation in the diagnosis of non-traumatic acute abdomen due to hollow viscus gastrointestinal pathology. The retrospective study included two hundred twenty-seven patients with abdominal pain admitted at the Emergency Department. Every patient underwent an initial POCUS examination. According to the clinical and sonographic findings, the patients were divided into three groups: patients with suspected inflammatory pathology of gastrointestinal origin, patients with bowel obstruction and patients with suspected gastrointestinal perforation. For each group, the sensitivity, specificity, and diagnostic accuracy were calculated and the coincidence of the initial clinical diagnosis and POCUS results with the discharge diagnosis based on intra-operative and histological findings was evaluated. Statistical analysis was performed using SPSS software for Windows version 16.0. POCUS could not detect any pathology in 31/227 (13.65%) cases, revealed a different diagnosis towards the clinical one in 7/227 (3.08%) and changed the treatment management in 33/227 (14.53%) patients. US diagnosis confirmed the clinical one in the inflammatory group in 56/57(98.24%); in the second one with ileus in 93/98 (94.89%) and in the third one with the perforation in 42/72 (58.33%) patients. A coincidence between the sonographic results and the discharge diagnosis was observed in 180/227 (79.29%) patients. POCUS could be a valuable and reliable first imaging modality for the diagnosis of non-traumatic acute abdomen due to hollow viscus gastrointestinal pathology.

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