The influence of intestinal sonography on the surgical approach to the acute abdomen

Differental diagnosis in patients with acute abdominal pain represents a difficult assignment in surgery involving the indication for urgent operation and the operation technique. Aim The value of sonography in diseases of the bowels for correct indication for early laparotomy was investigated. Method In a retrospective analysis we compared the result of sonography on 159 patients with acute abdominal pain with the first clinical assessment. Results The sensitivity of this technique was found to be 38.9 % for acute appendicitis, 57.1 % for diverticulitis and 76.9 % for obstructive ileus. The specificity ranged above 90 % in each case. In consideration of more than two sonomorphological criterias for pathological alterations of the intestines the positive predictive value achieved 100 %. Conclusion Low diagnostic sensitivity with high specificity implies the necessity to intensify routine ultrasonic investigation of the gut.