Hand-Carried and High-End Ultrasound Systems are Equally Inferior to Abdominal Radiography and Multidetector Computed Tomography in the Diagnosis of Pneumoperitoneum

Abstract

PURPOSE: Pneumoperitoneum (PP) is a severe finding in emergency departments. Its quick and correct diagnosis is indispensable for the further treatment of patients. The aim of this study was to analyze the clinical value of abdominal ultrasound performed with a modern hand-carried ultrasound (HCU) device as well as with a high-end ultrasound (HUS) system in the diagnosis of PP in patients with acute abdominal pain. MATERIALS AND METHODS: 31 patients with acute abdominal pain were enrolled in this study irrespective of their underlying disease, and examination with a latest generation HCU and a newest generation HUS was performed. Diagnosis of PP was based on findings of multidetector computed tomography (MDCT) and abdominal radiography (AR) as the standard of reference. The study was carried out by two independent and experienced examiners unaware of the diagnosis made by MDCT or AR. RESULTS: In five (16 %) patients PP was identified by MDCT and AR. Examination with HCU was calculated with a sensitivity and specificity of 80 % and 81 %, respectively. Examination with HUS yielded a sensitivity and specificity of 80 % and 89 %, respectively. CONCLUSION: PP can be detected by HCU and HUS with almost equal accuracy in patients with acute abdominal pain but both methods are inferior compared to MDCT and AR. However, HCU and HUS can accelerate the triage of patients and help to make decisions regarding the necessity of further examinations without the need for radiation and while reducing economic and logistic resources. KEY POINTS: 1. Pneumoperitoneum (PP) is a severe finding in emergency departments. 2. Hand-carried (HCU) and high-end (HUS) ultrasound systems can be helpful in detecting PP. 3. Abdominal radiography (AR) and multidetector computed tomography (MDCT) are superior in detecting PP. 4. HCU and HUS can accelerate the triage of patients. 5. HCU and HUS can be helpful when making decisions regarding the necessity of further examinations.