The diagnostic utility of abdominal ultrasound in adult patients presenting with non-traumatic abdominal pain to the emergency centre of Khayelitsha Hospital
Date
2022-12
Authors
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Journal ISSN
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Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: Introduction: Patients with non-trauma related acute abdominal pain often presents to
emergency centres. Ultrasound is frequently used to augment the clinical diagnosis but is still a scarce imaging modality in resource-limited settings. The aim of the study was to evaluate the utility of abdominal ultrasound in diagnosing adult patients with non-trauma related abdominal pain presenting to the emergency centre of an entry-level hospital in Cape Town. A secondary objective was to determine the agreement between the initial clinical impression, sonographic diagnosis, and the final discharge diagnosis. Methods: A retrospective chart review was conducted of adults (≥18-years) with acute nontrauma related abdominal pain and required an abdominal ultrasound ordered by emergency centre staff for a 6-month period (01 January 2019 – 30 June 2019). All ultrasound studies which assess the abdomen or part thereof were included. Patients with no ultrasound performed, obstetric-only ultrasounds, missing ultrasound report, or missing clinical records were excluded from analysis. Summary statistics were used to describe all variables. Results: A total of 88 patients were analysed of which 64 (72.7%) had an abnormal abdominal ultrasound examination. An urgent ultrasound diagnosis was identified in 34 (53.1%) patients. The median age was 36 years, predominantly female (70.5%), and most patients (85.1%) were triaged as routine or urgent. The predominant associated symptom reported was nausea and vomiting (20.5%). Most abnormal ultrasounds (28.1%) fell within the general surgical category. Fair agreement (κ=0.3) occurred between the ultrasound indication and the ultrasound diagnosis. Conclusion: Abdominal ultrasounds ordered by emergency centre staff were frequently abnormal and aided in the identification of an urgent diagnosis in half of these patients. It highlights the undocumented burden of non-trauma related abdominal pain in this low-tomiddle- income resource setting although no independent predictors of sonographic pathology were identifiable.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Description
Thesis (MMed)--Stellenbosch University, 2022.
Keywords
Diagnostic ultrasonic imaging, Abdomen -- Diseases -- Cape Town (South Africa), Abdominal pain -- Cape Town (South Africa), UCTD