![]() ![]() #SONOGRAM ABDOMEN FREE#FAST provides a quick overview of the peritoneal cavity to detect free fluid, which is a direct sign of hemoperitoneum and an indirect sign of organ injuries. HemoperitoneumĪbdominal US in trauma patients is typically performed with the methodology of a focused assessment with sonography for trauma (FAST) examination. Methods for the assessment of acute abdominal pain with point-of-care US must be developed according to the accumulated evidence in each abdominal region. Įvidence on detection of each lesion causing acute abdominal pain with point-of-care abdominal US is reviewed in the “ Detection of abdominal and pelvic lesions” section. ![]() The number of US performed in the radiology department was significantly lower in the group receiving surgeon-performed US, while there was no difference between the groups regarding the number of ordered CT scans or other examinations. The proportion of correct primary diagnoses was 7.9 % higher in the group undergoing surgeon-performed US than in the control group (64.7 vs 56.8 % p = 0.027). reported the utility of US performed by surgeons who underwent a 4-week US training program. In a randomized study including 800 adult patients with acute abdominal pain, Lindelius et al. In 128 patients, 58 (45 % 95 % confidence interval (CI), 36–54 %) had an improvement in diagnostic accuracy and planned diagnostic workup using US. In this regard, imaging strategies including point-of-care abdominal US must also be evaluated.Ī pilot observational study showed that emergency physician (EP)-performed US appears to positively impact decision-making and the diagnostic workup of patients with nonspecific abdominal pain as determined by the nursing triage. reported that conditional strategy with CT after negative or inconclusive radiology US resulted in the highest overall sensitivity, with only 6 % missed urgent conditions, and the lowest overall exposure to radiation by performing CT in only half of adult patients with acute abdominal pain. Although a greater accumulation of evidences is needed in some fields, point-of-care abdominal US is a promising modality to improve patient care in emergency and critical care settings.Ĭlinical manifestations and point-of-care US Acute abdominal painĪs a single imaging strategy, computed tomography (CT) is overall superior to US in patients with acute abdominal pain. US-guided catheterization with transrectal pressure appears to be useful in some male patients in whom standard urethral catheterization is difficult. The estimation of the amount of urine with bladder US can lead to an increased success rate in small children. US appears to be a potential modality to verify the placement of the gastric tube. Paracentesis under US guidance has been shown to improve patient care. Additionally, point-of-care US can be a modality for assisting procedures. It may also be useful for the diagnoses of digestive tract diseases such as appendicitis, small bowel obstruction, and gastrointestinal perforation. It can be used with great accuracy to detect the presence of abdominal aortic aneurysm in symptomatic patients. Point-of-case US is justified as the initial imaging modality for the diagnosis of ureterolithiasis and the assessment of pyelonephritis. It is particularly useful for the detection of gallstones and the diagnosis of acute cholecystitis. Utilization of point-of-care US is also considered in order to detect abdominal and pelvic lesions. For the assessment of systemic hypoperfusion and renal dysfunction, point-of-care renal Doppler US may be an option. To detect hemoperitoneum, the methodology of a focused assessment with sonography for a trauma examination may also be an option in non-trauma patients. Methods for the assessment of acute abdominal pain with point-of-care US must be developed according to accumulated evidence in each abdominal region. Point-of-care abdominal ultrasound (US), which is performed by clinicians at bedside, is increasingly being used to evaluate clinical manifestations, to facilitate accurate diagnoses, and to assist procedures in emergency and critical care. ![]()
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