Evaluation of abdominal ultrasound performed by the gastroenterologist in the office.

GOALS

To evaluate the utility of gastroenterologist operated abdominal ultrasound (US) in a community practice.

BACKGROUND

Imaging is frequently required to guide management of patients with abdominal disorders. In the United States, gastroenterologists do not perform abdominal US on their own patients.

STUDY

Retrospective review of patients who underwent US by a gastroenterologist. Diagnostic accuracy of US was assessed on patients who underwent subsequent analysis with computed tomography, magnetic resonance imaging, or endoscopic retrograde cholangiopancreatography.

RESULTS

A total of 310 patients were examined during their office visit over a period of 10 months. Abdominal pain (64%) and abnormal liver function tests (16%) were the most common indications. US did not detect any pathologies in 149 (48%) patients. Abnormal US were observed in 161 patients (52%). The most common abnormal US findings were fatty liver (21%) and biliary abnormalities (19%). US examination provided clinical useful findings guiding the management in 200 patients (65%); 22 patients (7%) showed severe abnormalities that required urgent management. The initial US interpretation was correct in all 22 cases. Among the 310 patients, 84 (27%) underwent subsequent computed tomography, magnetic resonance imaging, or endoscopic retrograde cholangiopancreatography within a period of 1 month. A normal US diagnosis was confirmed in 35 (88%) of 40 patients. Abnormal US results were confirmed in 41 (93%) of 44 patients. US missed 3 (4%) significant clinical lesions (choledocholithiasis, cirrhosis, and ureteral stone); CT misinterpreted 2 (2%) patients (cholelithiasis and dilated biliary tract).

CONCLUSIONS

Gastroenterologist-operated US provides instant and accurate information relevant to the diagnosis and management of abdominal disorders.