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Introduction
Abdominal pain is one of the most common symptoms prompting patients to visit hospitals. Among such individuals, a number of patients have serious diseases and require subsequent hospitalization or surgery. Diagnosis may consist of acute appendicitis, intestinal obstruction and other serious conditions such as bowel necrosis and intestinal volvulus (1). Correct and prompt diagnosis is essential for the appropriate management of patients. Diagnosis of patients with abdominal pain is primarily determined by imaging techniques, such as radiography, abdominal ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) (2). Among these, abdominal US is a non-invasive procedure, which is readily available at most hospitals even during off-hours (weekends, nights and holidays) and may be performed at the bedside (3).
Abdominal US is indispensable for the diagnosis of diseases in the abdominal cavity in patients with abdominal symptoms (4,5). In addition, abdominal US is also useful for the diagnosis of solid organ conditions, including acute cholangitis, acute cholecystitis and acute pancreatitis (6–8). Abdominal US is also useful in the diagnosis of bowel disease based on pathological findings (9,10). Diagnostic criteria with abdominal US have been established for acute appendicitis and colonic diverticulitis (11–14) and colorectal cancer may be diagnosed with abdominal US (15). In numerous cases, patients are diagnosed by a combination of laboratory data and diagnostic imaging findings based on symptoms and physical examination. With regards to diagnostic imaging, CT is recommended as the first-line procedure (16); however, CT is not readily available during off-h at the majority of hospitals. In these cases, abdominal US is the first-line procedure performed.
On the basis of the aforementioned considerations, the current study retrospectively analyzed the records of patients who underwent abdominal US as a first-line diagnostic imaging procedure in order to evaluate its utility and limitations in determining the diagnosis of patients presenting with abdominal symptoms.
Materials and methods
Patients
Medical records were retrospectively analyzed for 76 patients who were subjected to abdominal US as the first-line diagnostic imaging modality at the National Hospital Organization Shimoshizu Hospital (Yotsukaido, Japan) from April 2010 to April 2015. Abdominal US was performed at the time of consultation or during off-hours (weeknights, weekends and holidays). Recruited patients were restricted to those in which abdominal US was performed as a first...