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 wa s investigated. Method In a retrospective analysis we compared the res ult of sonography on 159 patients with acute abdominal pain with the f irst clinical assessment. Results The sensitivity of this technique wa s found to be 38.9 % for acute appendicitis, 57.1 % for diverticulitis and 76.9 % for obstructive ileus. The specificity ranged above 90 % i n each case. In consideration of more than two sonomorphological crite rias for pathological alterations of the intestines the positive predi ctive value achieved 100 %. Conclusion Low diagnostic sensitivity with high specificity implies the necessity to intensify routine ultrasoni c investigation of the gut.