[Does routine ultrasonography of the abdominal organs affect the subsequent management of the patient?]

When abdominal ultrasound is performed it is general practice to examine not only the organs needed to answer the clinician's question but also the remaining abdominal and pelvic organs for which there is no clinical indication (= routine examinations). We investigated the effect of these routine examinations on the further management in 533 medical outpatients (222 women; 311 men; age 45 +/- 16 years). Of 7684 organs examined, 6194 (81%) were routine examinations, 469 of which revealed unexpected abnormalities. Only 19 of these were considered clinically relevant enough to warrant further work-up, and long-term follow-up was regarded as necessary in 6 patients only. However, an abnormal finding on routine examination had no eventual therapeutic implications in any patient. We conclude that in middle-aged medical outpatients it is sufficient to perform sonography on those abdominal and pelvic organs which need to be examined to answer the clinician's questions. Failure to routinely examine the remaining organs does not lead to a relevant loss of information, but may save time and money on fruitless work-up of unexpected findings.