US in the evaluation of abdominal pain in a department of internal medicine

美国在内科部门对腹痛的评估

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Abstract

INTRODUCTION: US (US) examination of the abdomen has acquired a growing role in the investigation of abdominal pain; however its role in the diagnosis of some important causes of abdominal pain is still under investigation. The aim of this study was to evaluate the role of US of the abdomen in the diagnosis of abdominal pain in patients referred to a department of internal medicine. MATERIALS AND METHODS: A retrospective analysis was carried out on 248 US examinations performed in our department due to abdominal pain. For each examination the data written on the request form were registered as well as US findings which could be correlated with abdominal pain. RESULTS: In 105 patients (42%), US examination of the abdomen resulted in a relevant clinical finding and was thus considered positive. A high percentage of patients were elderly (>65 years; 52%) and very elderly (>80 years; 24%); these patients showed a significantly higher percentage of positive US scans. The proportion of positive scans was not significantly different between localized and non-localized pain. Specific pain location was associated with US findings such as hepatic masses, ovarian masses and renal stones, whereas non-localized pain was associated with abdominal free fluid and fluid-distended bowel loops. DISCUSSION: A high percentage of US examinations identified conditions that could possibly cause abdominal pain. Diagnostic yield of abdominal US was higher in elderly and very elderly patients. When a US examination is requested, it should always be evaluated within the clinical context. The physician should be aware of the great value of abdominal US in the diagnosis of the various causes of abdominal pain, but also of its possible limitations.

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