Are we overusing ultrasound in non-traumatic acute abdominal pain?

Ultrasound is being used increasingly in the assessment of acute non-traumatic abdominal pain as it is non-invasive and does not carry the risk of radiation. However, the inappropriate use of ultrasound can lead to a delayed or incorrect diagnosis, more work for the personnel involved, and increased hospital costs.

A prospective study was conducted to analyse the clinical indications for requesting an ultrasound in those admitted to a district general hospital with acute non-traumatic abdominal pain, and to assess whether there is a correlation between clinical and laboratory findings and ultrasound results. A total of 110 patients were studied during a three month period.

The results suggest that ultrasound is useful in the investigation of suspected biliary colic and abdominal masses. However, the yield of ultrasound in other patients with acute non-traumatic abdominal pain is low. This study also suggests that the yield of "positive" reports on ultrasound is significantly higher in patients with localised abdominal pain and tenderness and in those with acute abdominal pain and a raised white cell count or raised liver function tests. The yield of positive reports in patients with acute abdominal pain was found to be lower those less than 25 years of age than in older patients.