[Abdominal ultrasound as a screening method]

Abdominal ultrasound is increasingly used as part of the initial patient evaluation, without a specific indication. However, such an indiscriminate use of abdominal ultrasound is still controversial. The review of available literature on the value of abdominal ultrasound in clinical screening suggests the following conclusions: 1) The primary screening examination of asymptomatic persons leads to clinically relevant findings in less than 0.5% of cases. However, approximately 50% of the persons examined have abnormal findings without clinical relevance. This high frequency of abnormal findings may cause high costs due to unnecessary follow-up examinations. 2) A sonographic screening of asymptomatic persons may, however, be useful for specific indications in preselected individuals. This has been demonstrated for the detection of abdominal aortic aneurysm in the age group over 65 years. 3) Routine abdominal ultrasound in patients with a known internal disease appears to be useful even in the absence of a specific indication. This 'secondary screening' yields unexpected findings which turn out to be relevant for therapeutic decisions or for the final diagnosis in 6-25% of the cases. Routine abdominal ultrasound of all patients with internal disease may thus be a valuable extension of the initial patient evaluation.