ULTRASOUND SCANNING OF THE ACUTE ABDOMEN BY SURGEONS IN-TRAINING

Ultrasound is widely used in the investigation of abdominal symptoms. Its increasing popularity may lead to pressure on radiological service s, diagnostic delay and prolonged hospital stay. Immediate imaging per formed by radiologists can contribute useful information in acute emer gencies. This study assessed the accuracy and value of abdominal ultra sonography when carried out by admitting surgeons. Three surgical regi strars were first instructed for two half days by a consultant radiolo gist. Patients with acute symptoms were scanned at the time of initial presentation using an Aloka SSD-620 scanner with 3.5 and 5 MHz probes . A total of 205 scans was performed-124 of the upper and 81 of the lo wer abdomen. Immediate ultrasound provided information that contribute d to the establishment or refutal of a diagnosis in 138 patients (67.3 %), predominantly by confirming or excluding hepatobiliary disease, tu bo-ovarian pathology or aortic aneurysms and in blunt abdominal trauma . The diagnosis was altered in a small proportion (7.8%). Scanning pro ved unhelpful in 62 patients and misleading in five. Findings concurre d with those of a radiologist in 86% of the 139 patients subsequently scanned. Abdominal ultrasound is a useful tool in the hands of surgeon s dealing with emergencies and may occasionally provide vital informat ion. If access to radiological facilities is delayed, ultrasound by th e admitting surgeon could lead to improved patient management and cost savings.