Skip to main content
SpringerLink
Log in

Point-of-Care Ultrasound in the Diagnosis of Acute Abdominal Pain

  • Chapter
Operative Techniques and Recent Advances in Acute Care and Emergency Surgery

Abstract

Ultrasound performed by the emergency physician has a high degree of accuracy in most common abdominal conditions characterized by acute abdominal pain and can give real-time answers in unstable or septic patients where the choice of antibiotic therapy, and need of an early surgical operation, can be lifesaving. Point-of-care ultrasound is a real-time, often available, dynamic examination with the possibility to convey dynamic information about bowel motility and changes in position and can also depict visceral blood flow. Bedsides ultrasonography may be as accurate as CT to detect ruptured abdominal aortic aneurysms, biliary tract diseases, complications of acute pancreatitis, acute appendicitis, Crohn’s disease, bowel obstruction and perforation, and gynecological emergencies. In nonobese patients, sonography can also be useful in diverticulitis, with a high sensitivity and specificity for the primary complications. Ultrasound is well established as the first-line imaging modality for diagnosing intussusception in children, but even in the adult population, bowel sonography can be very useful. Ultrasound may also detect other frequent causes of inflammatory and intestinal obstruction and rarer causes such as volvulus, ascariasis, superior mesenteric artery syndrome, gallstone ileus, bezoars, afferent loop syndrome, foreign bodies, and Crohn’s disease. Ultrasound can also be used to identify complications of ischemic bowel disease, such as pneumatosis intestinalis, portal venous gas, and pneumoperitoneum. Point-of-care ultrasound is the first imaging tool to evaluate women with acute pelvic pain. It has good accuracy to detect or rule out gynecologic disorders and can evaluate those conditions of acute abdominal pain that may require immediate surgery such as ectopic pregnancy and hemorrhagic ovarian cysts.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. McCaig LG, Stussamm BJ. National Hospital Ambulatory Medical Care Survey: 1996 Emergency Department Summary. Adv Data. 1997; (293):1–20.

    Google Scholar 

  2. Tintinalli JE. Emergency medicine. New York: McGraw-Hill Education; 2016.

    Google Scholar 

  3. Cartwright SL, Knudson MP. Evaluation of acute abdominal pain in adults. Am Fam Physician. 2008;77:971–8. Review

    PubMed  Google Scholar 

  4. Scaglione M. Imaging features and differential diagnosis for a timely management approach. Emergency radiology of the abdomen. 1st ed. Heidelberg: Springer; 2012. p. 133–64.

    Google Scholar 

  5. Lameris W, van Randen A, van Es HW, van Heesewijk JP, van Ramshorst B, Bouma WH, et al. Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study. BMJ. 2009;338:b2431.

    PubMed  PubMed Central  Google Scholar 

  6. Laurell H, Hansson LE, Gunnarsson U. Diagnostic pitfalls and accuracy of diagnosis in acute abdominal pain. Scand J Gastroenterol. 2006;41:1126–35.

    PubMed  Google Scholar 

  7. Prasannan S, Zhueng TJ, Gul YA. Diagnostic value of plain abdominal radiographs in patients with acute abdominal pain. Asian J Surg. 2005;28:246–51.

    PubMed  Google Scholar 

  8. MacKersie AB, Lane MJ, Gerhardt RT, Claypool HA, Keenan S, Katz DS, et al. Nontraumatic acute abdominal pain: unenhanced helical CT compared with three-view acute abdominal series. Radiology. 2005;237:114–22.

    PubMed  Google Scholar 

  9. Gans SL, Pols MA, et al. Guideline for the diagnostic pathway in patients with acute abdominal pain. Dig Surg. 2015;32:23–31. https://doi.org/10.1159/00037158.

    Article  PubMed  Google Scholar 

  10. Rosen MP, Ding A, Blake MA, Baker ME, Cash BD, Fidler JL, Grant TH, Greene FL, Jones B, Katz DS, Lalani T, Miller FH, Small WC, Spottswood S, Sudakoff GS, Tulchinsky M, Warshauer DM, Yee J, Coley BD. ACR Appropriateness Criteria® right lower quadrant pain–suspected appendicitis. J Am Coll Radiol. 2011;8:749–55. Review

    PubMed  Google Scholar 

  11. Cortellaro F, Ferrari L, et al. Accuracy of point of care ultrasound to identify the source of infection in septic patients: a prospective study. Intern Emerg Med. 2016;12(3):371–8.

    PubMed  Google Scholar 

  12. Lederle FA, Johnson GR, Wilson SE, Chute EP, Littooy FN, Bandyk D, et al. Prevalence and associations of abdominal aortic aneurysm detected through screening. Aneurysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Group. Ann Intern Med. 1997;126:441–9.

    CAS  PubMed  Google Scholar 

  13. Sakalihasan N, Limet R, Defawe OD. Abdominal aortic aneurysm. Lancet. 2005;365:1577–89.

    CAS  PubMed  Google Scholar 

  14. Thompson MM. Controlling the expansion of abdominal aortic aneurysms. Br J Surg. 2003;98:897–8.

    Google Scholar 

  15. Chichester Aneurysm Screening Group. Viborg Aneurysm Screening Study, Western Australian Abdominal Aortic Aneurysm Program, Multicentre Aneurysm Screening Study. A comparative study of the prevalence of abdominal aortic aneurysms in the United Kingdom, Denmark, and Australia. J Med Screen. 2001;8:46–50.

    Google Scholar 

  16. Norman PE, Powell JT. Abdominal aortic aneurysm: the prognosis in women is worse than in men. Circulation. 2007;115:2865–9.

    CAS  PubMed  Google Scholar 

  17. U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Health Statistics. MD LCWK1. Deaths, percent of total deaths, and death rates for the 15 leading causes of death in 5-year age groups, by race and sex: United States, 2006. 2009. [10/11/09]. pp. 7–9.

    Google Scholar 

  18. Lederle FA, Johnson GR, Wilson SE, Ballard DJ, Jordan WDJ, Blebea J, et al. Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair. JAMA. 2002;287:2968–72.

    PubMed  Google Scholar 

  19. Hoffman M, Avellone JC, Pleecha GR, et al. Operation for ruptured abdominal aortic aneurysm: a community-wide experience. Surgery. 1982;91:597.

    CAS  PubMed  Google Scholar 

  20. Kiell CS, Ernst CB. Advances in management of abdominal aortic aneurysm. Adv Surg. 1993;26:73–98.

    CAS  PubMed  Google Scholar 

  21. Lindholt JS, Vammen S, Juul S, Henneberg EW, Fasting H. The validity of ultrasonographic scanning as screening method for abdominal aortic aneurysm. Eur J Vasc Endovasc Surg. 1999;17:472–5.

    CAS  PubMed  Google Scholar 

  22. Costantino TG, Bruno EC, Handly N, Den AJ. Accuracy of emergency medicine ultrasound in the evaluation of abdominal aortic aneurysm. J Emerg Med. 2005;29(4):455–60.

    PubMed  Google Scholar 

  23. Lederle FA, Wilson SE, Johnson GR, Reinke DB, Littooy FN, Acher CW, et al. Variability in measurement of abdominal aortic aneurysms. Abdominal Aortic Aneurysm Detection and Management Veterans Administration Cooperative Study Group. J Vasc Surg. 1995;21:945–52.

    CAS  PubMed  Google Scholar 

  24. Testa A, Lauritano EC, Giannuzzi R, Pignataro G, Casagranda I, Gentiloni Silveri N. The role of emergency ultrasound in the diagnosis of acute non-traumatic epigastric pain. Intern Emerg Med. 2010;5(5):401–9.

    PubMed  Google Scholar 

  25. Johnson CD. ABC of the upper gastrointestinal tract. Upper abdominal pain: gall bladder. BMJ. 2001;323(7322):1170–3.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Grimpen F, Pavli P. Rational investigation of upper abdominal pain. Aust Fam Physician. 2008;37(8):602–7.

    PubMed  Google Scholar 

  27. Rubens DJ. Ultrasound imaging of the biliary tract. Ultrasound Clin. 2007;2:391–413.

    Google Scholar 

  28. Menu Y, Vuillerme M-P. Non-traumatic abdominal emergencies: Imaging and intervention in acute biliary conditions. In: Marincek B, Dondelinger RF, editors. Emergency radiology. Berlin: Springer; 2007. p. 481–91.

    Google Scholar 

  29. Steven M, Strasberg MD. Acute calculous cholecystitis. N Engl J Med. 2008;358:2804–11.

    Google Scholar 

  30. Shea JA, Berlin JA, Escarce JJ, et al. Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease. Arch Intern Med. 1994;154:2573–81.

    CAS  PubMed  Google Scholar 

  31. Guyatt G, Rennie D, for the Evidence-Based Medicine Working Group, American Medical Association. Users’ guides to the medical literature: a manual for evidence-based clinical practice. Chicago, IL: AMA Press; 2002.

    Google Scholar 

  32. Trowbridge RL, Rutkowski NK, Shojania KG. Does this patient have acute cholecystitis. JAMA. 2009;289:80–6.

    Google Scholar 

  33. Harvey RT, Miller WT Jr. Acute biliary disease. Radiology. 1999;213:831–6.

    CAS  PubMed  Google Scholar 

  34. Reginelli A, Pezzullo MG, Scaglione M, Scialpi M, Brunese L, Grassi R. Gastrointestinal disorders in elderly patients. Radiol Clin N Am. 2008;46(4):755–71.

    CAS  PubMed  Google Scholar 

  35. Ralls PW, Colletti PM, Lapin SA, et al. Real-time sonography in suspected acute cholecystitis: prospective evaluation of primary and secondary signs. Radiology. 1985;155:767–71.

    CAS  PubMed  Google Scholar 

  36. Van Breda Vriesman AC, Engelbrecht MR, Smithuis RH, Puylaert JB. Diffuse gallbladder wall thickening: differential diagnosis. Am J Roentgenol. 2007;188:495–501.

    Google Scholar 

  37. Takada T, Strasberg SM, Solomkin JS, Pitt HA, et al. Tokyo Guidelines Revision Committee. TG13:Updated Tokyo Guidelines for the management of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2013;20(1):1–7.

    PubMed  Google Scholar 

  38. Ansaloni L, Pisano M, Coccolini F, Peitzmann AB, et al. WSES guidelines on acute calculous cholecystitis. World J Emerg Surg. 2016;11:25.

    CAS  PubMed  PubMed Central  Google Scholar 

  39. Larson SD, Nealon WH, Evers BM. Management of gallstone pancreatitis. Adv Surg. 2006;40:265–84.

    PubMed  Google Scholar 

  40. Vilgrain V, Palazzo L. Choledocholithiasis: role of US and endoscopic ultrasound. Abdom Imaging. 2001;26:7–14.

    CAS  PubMed  Google Scholar 

  41. Neoptolemos JP, Hall AW, Finlay DF, Berry JM, CarrLocke DL, Fossard DP. The urgent diagnosis of gallstones in acute pancreatitis: a prospective study of three methods. Br J Surg. 1984;71:230–3.

    CAS  PubMed  Google Scholar 

  42. Șurlin V, Săftoiu A, Dumitrescu D. Imaging tests for accurate diagnosis of acute biliary Pancreatitis. World J Gastroenterol. 2014;20(44):16544–9.

    PubMed  PubMed Central  Google Scholar 

  43. Koo BC, Chinogureyi A, Shaw AS. Imaging acute pancreatitis. Br J Radiol. 2010;83(986):104–12.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. Barrett ML, Hines AL, Andrews RM. Trends in rates of perforated appendix, 2001–2010. HCUP Statistical Brief #159. July 2013.

    Google Scholar 

  45. United Kingdom National Surgical Research Collaborative, Bhangu A. Safety of short, in-hospital delays before surgery for acute appendicitis: multicentre cohort study, systematic review, and meta-analysis. Ann Surg. 2014;259(5):894–903.

    Google Scholar 

  46. Velanovich V, Satava R. Balancing the normal appendectomy rate with the perforated appendicitis rate: implications for quality assurance. Am Surg. 1992;58(4):264–9.

    CAS  PubMed  Google Scholar 

  47. Kirkil C, et al. Appendicitis scores may be useful in reducing the costs of treatment for right lower quadrant pain. Ulus Travma Acil Cerrahi Derg. 2013;19(1):13–9.

    PubMed  Google Scholar 

  48. Hallan S, Asberg A. The accuracy of C-reactive protein in diagnosing acute appendicitis–a meta-analysis. Scand J Clin Lab Invest. 1997;57(5):373–80.

    CAS  PubMed  Google Scholar 

  49. Ohle R, et al. The Alvarado score for predicting acute appendicitis: a systematic review. BMC Med. 2011;9:139.

    PubMed  PubMed Central  Google Scholar 

  50. Debnath J, et al. Alvarado score: is it time to develop a clinical-pathological- radiological scoring system for diagnosing acute appendicitis? Am J Emerg Med. 2015;33(6):839–40.

    PubMed  Google Scholar 

  51. Atema JJ, et al. Scoring system to distinguish uncomplicated from complicated acute appendicitis. Br J Surg. 2015;102(8):979–90.

    CAS  PubMed  Google Scholar 

  52. Chang ST, Jeffrey RB, Olcott EW. Three-step sequential positioning algorithm during sonographic evaluation for appendicitis increases appendiceal visualization rate and reduces CT use. AJR Am J Roentgenol. 2014;203(5):1006–12.

    PubMed  Google Scholar 

  53. Nielsen JW, et al. Reducing computed tomography scans for appendicitis by introduction of a standardized and validated ultrasonography report template. J Pediatr Surg. 2015;50(1):144–8.

    PubMed  Google Scholar 

  54. Koseekriniramol V, et al. Abdominal wall thickness is not useful to predict appendix visualization on sonography in adult patients with suspected appendicitis. J Clin Ultrasound. 2015;43(5):269–76.

    PubMed  Google Scholar 

  55. Chesbrough RM, et al. Self-localization in US of appendicitis: an addition to grades compression. Radiology. 1993;187:349–51.

    CAS  PubMed  Google Scholar 

  56. Fields MJ, et al. Accuracy of point of care ultrasonography for diagnosing acute appendicitis: a systematic review and meta-analysis. Acad Emerg Med. 2017;24(9):1124–36.

    Google Scholar 

  57. Saverio D, et al. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis. World J Emerg Surg. 2016;11:34.

    PubMed  PubMed Central  Google Scholar 

  58. Maconi G, Sampietro GM, Sartani A, Bianchi Porro G. Bowel ultrasound in Crohn’s disease: surgical perspective. Int J Color Dis. 2008;23:339–47.

    Google Scholar 

  59. Maconi G, Radice E, Greco S, Bianchi Porro G. Bowel ultrasound in Crohn’s disease. Best Pract Res Clin Gastroenterol. 2006;20:93–112.

    PubMed  Google Scholar 

  60. Panes J, Bouhnik Y, Reinisch W, Stoker J, Taylor SA, Baumgart DC, et al. Imaging techniques for assessment of inflammatory bowel disease: joint ECCO and ESGAR evidence-based consensus guidelines. J Crohns Colitis. 2013;7:556–85.

    CAS  PubMed  Google Scholar 

  61. Novak K, Tanyingoh D, Petersen F, Kucharzik T, Panaccione R, Ghosh S, et al. Clinic-based point of care transabdominal ultrasound for monitoring Crohn’s disease: impact on clinical decision making. J Crohns Colitis. 2015;9:795–801.

    PubMed  Google Scholar 

  62. Panés J, Bouzas R, Chaparro M, García-Sánchez V, Gisbert JP, Martínez de Guereñu B, et al. Systematic review: the use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn’s disease. Alim Pharmacol Ther. 2011;34:125–45.

    Google Scholar 

  63. Hammond NA, Nikolaidis P, Miller FH. Left lower-quadrant pain: guidelines from the American College of Radiology appropriateness criteria. Am Fam Physician. 2010;82:766–70. Review

    PubMed  Google Scholar 

  64. Jacobs DO. Clinical practice. Diverticulitis. N Engl J Med. 2007;357:2057–66. Review

    CAS  PubMed  Google Scholar 

  65. Hollerweger A, Macheiner P, Rettenbacher T, Brunner W, Gritzmann N. Colonic diverticulitis: diagnostic value and appearance of inflamed diverticula-sonographic evaluation. Eur Radiol. 2001;11:1956–63.

    CAS  PubMed  Google Scholar 

  66. Cuccurullo V, Cioce F, Sica A, Iasiello F, Capasso R, Gatta G, Rubini G. Gastroenteric diseases in the third millennium: a rational approach to optimal imaging technique and patient selection. Recenti Prog Med. 2012;103(11):426–30.

    PubMed  Google Scholar 

  67. Tack D, Bohy P, Perlot I, De Maertelaer V, Alkeilani O, Sourtzis S, Gevenois PA. Suspected acute colon diverticulitis: imaging with low-dose unenhanced multi-detector row CT. Radiology. 2005;237:189–96.

    PubMed  Google Scholar 

  68. van Randen A, Laméris W, van Es HW, van Heesewijk HP, van Ramshorst B, Ten Hove W, Bouma WH, van Leeuwen MS, van Keulen EM, Bossuyt PM, Stoker J, Boermeester MA, OPTIMA Study Group. A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain. Eur Radiol. 2011;21:1535–45.

    PubMed  PubMed Central  Google Scholar 

  69. Klarenbeek BR, de Korte N, van der Peet DL, Cuesta MA. Review of current classifications for diverticular disease and a translation into clinical practice. Int J Color Dis. 2012;27:207–14. Review

    Google Scholar 

  70. Jang HJ, Lim HK, Lee SJ, Lee WJ, Kim EY, Kim SH. Acute diverticulitis of the cecum and ascending colon: the value of thin-section helical CT findings in excluding colonic carcinoma. Am J Roentgenol. 2000;174:1397–402.

    CAS  Google Scholar 

  71. Sai VF, Velayos F, Neuhaus J, Westphalen AC. Colonoscopy after CT diagnosis of diverticulitis to exclude colon cancer: a systematic literature review. Radiology. 2012;263:383–90. Review, Erratum in: Radiology 2012, 264:306

    PubMed  PubMed Central  Google Scholar 

  72. Andeweg CS, et al. Toward an evidence-based step-up approach in diagnosing diverticulitis. Scand J Gastroenterol. 2014;49:775–84.

    PubMed  Google Scholar 

  73. Baker JB, et al. Diagnosis of diverticulitis by bedside ultrasound in the Emergency department. J Emerg Med. 2006;30(3):327–9.

    PubMed  Google Scholar 

  74. Helou N, et al. Sonography: first-line modality in the diagnosis of acute colonic diverticulitis? J Ultrasound Med. 2013;32:1689–94.

    PubMed  Google Scholar 

  75. Talabani AJ, et al. Clinical diagnostic accuracy of acute colonic diverticulitis in patients admitted with acute abdominal pain, a receiver operating characteristic curve analysis. Int J Color Dis. 2017;32:41–7.

    Google Scholar 

  76. Sartelli M, Catena F, et al. WSES Guidelines for the management of acute left sided colonic diverticulitis in the emergency setting. World J Emerg Surg. 2016;11:37.

    PubMed  PubMed Central  Google Scholar 

  77. Salem TA, Molloy RG, O’Dwyer PJ. Prospective, five-year follow-up study of patients with symptomatic uncomplicated diverticular disease. Dis Colon Rectum. 2007;50:1460–4.

    PubMed  Google Scholar 

  78. Ambrosetti P. Acute diverticulitis of the left colon: value of the initial CT and timing of elective colectomy. J Gastrointest Surg. 2008;12:1318–20. Review

    PubMed  Google Scholar 

  79. Lameris W, van Randen A, et al. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol. 2008;18:2498–511.

    PubMed  Google Scholar 

  80. Mazzei MA, et al. Sigmoid diverticulitis: US findings. Crit Ultrasound J. 2013;5:S1/S5.

    Google Scholar 

  81. Liljegren G, Chabok A, Wickbom M, et al. Acute colonic diverticulitis: a systematic review of diagnostic accuracy. Color Dis. 2007;9:480–8.

    CAS  Google Scholar 

  82. Patak MA, Mortele KJ, Ros PR. Multidetector row CT of the small bowel. Radiol Clin N Am. 2005;43:1063–77.

    PubMed  Google Scholar 

  83. Unluer EE, Yavasi O, Eroglu O, Yilmaz C, Akarca FK. Ultrasonography by emergency medicine and radiology residents for the diagnosis of small bowel obstruction. Eur J Emerg Med. 2010;17:260–4.

    PubMed  Google Scholar 

  84. Muradali D, Goldberg DR. US of gastrointestinal tract disease. Radiographics. 2015;35(1):50–68.

    PubMed  Google Scholar 

  85. Ødegaard S, Nesje LB, Lærum OD, Kimmey MB. High-frequency ultrasonographic imaging of the gastrointestinal wall. Expert Rev Med Devices. 2012;9(3):263–73.

    PubMed  Google Scholar 

  86. Maconi G, Porro GB. Ultrasound of the gastrointestinal tract. Berlin: Springer; 2007. p. 27–34.

    Google Scholar 

  87. Silva AC, Pimenta M, Guimarães LS. Small bowel obstruction: what to look for. Radiographics. 2009;29:423–39.

    PubMed  Google Scholar 

  88. Scheible W, Goldberger LE. Diagnosis of small bowel obstruction: the contribution of diagnostic ultrasound. AJR Am J Roentgenol. 1979;133:685–8.

    CAS  PubMed  Google Scholar 

  89. Guttman J, Stone MB, Kimberly HH, Rempell JS. Point-of-care ultrasonography for the diagnosis of small bowel obstruction in the emergency department. CJEM. 2015;17(2):206–9.

    PubMed  Google Scholar 

  90. Grassi R, Romano S, D’amario F, et al. The relevance of free fluid between intestinal loops detected by sonography in the clinical assessment of small bowel obstruction in adults. Eur J Radiol. 2004;50(1):5–14.

    PubMed  Google Scholar 

  91. Wilson SR. The acute abdomen of gastrointestinal tract origin: sonographic evaluation. In: Margulis AR, Burhenne HJ, editors. Alimentary tract radiology. 5th ed. St. Louis: Mosby; 1994. p. 2099–117.

    Google Scholar 

  92. Jaffe T, Thompson WM. Large-bowel obstruction in the adult: classic radiographic and CT findings, etiology, and mimics. Radiology. 2015;275(3):651–63.

    PubMed  Google Scholar 

  93. Taylor M. Adult small bowel obstruction. Acad Emerg Med. 2013;20:528–44.

    PubMed  Google Scholar 

  94. Jae Hoon Lim. Ultrasound examination of gastrointestinal tract disease. J Korean Med Sci. 2000;15:371–9.

    Google Scholar 

  95. Carpenter CR, Pines JM. The end of x-rays for suspected small bowel obstruction? Using evidence based diagnostics to inform best practices in emergency medicine. Acad Emerg Med. 2013;20:618–20.

    PubMed  Google Scholar 

  96. Ogata M, Mateer JR, Condon RE. Prospective evaluation of abdominal sonography for the diagnosis of bowel obstruction. Ann Surg. 1996;223:237–41.

    CAS  PubMed  PubMed Central  Google Scholar 

  97. Ko YT, Lim JH, Lee DH, Lee HW, Lim JW. Small bowel obstruction: sonographic evaluation. Radiology. 1993;188(3):649–53.

    CAS  PubMed  Google Scholar 

  98. Akbulut S. Intussusception due to inflammatory fibroid polyp: a case report and comprehensive literature review. World J Gastroenterol. 2012;18:5745–52.

    PubMed  PubMed Central  Google Scholar 

  99. Marinis A, Yiallourou A, Samanides L, et al. Intussusception of the bowel in adults: a review. World J Gastroenterol. 2009;15:407–11.

    PubMed  PubMed Central  Google Scholar 

  100. Rafailidis V, Phillips C, Yusuf G, Sidhu P. A case of adult intussusception with greyscale, contrast-enhanced ultrasound and computerised tomography correlation. Ultrasound. 2017;25(2):120–5.

    PubMed  Google Scholar 

  101. Weissberg DL, Scheible W, Leopold GR. Ultrasonographic appearance of adult intussusception. Radiology. 1977;124:791–2.

    CAS  PubMed  Google Scholar 

  102. Boyle MJ, Arkell LJ, Williams JT. Ultrasonic diagnosis of adult intussusception. Am J Gastroenterol. 1993;88:617–8.

    CAS  PubMed  Google Scholar 

  103. Light D, Ratnasingham K, Banerjee A, Cadwallader R, Uzzaman MM, Gopinath B. The role of ultrasound scan in the diagnosis of occult inguinal hernias. Int J Surg. 2011;9(2):169–72.

    CAS  PubMed  Google Scholar 

  104. Jain N, Goyal N, Mukherjee K, Kamath S. Ultrasound of the abdominal wall: what lies beneath? Clin Radiol. 2013;68:85–93.

    CAS  PubMed  Google Scholar 

  105. Lim JH. Ultrasound examination of gastrointestinal tract diseases. J Korean Med Sci. 2000;15:371–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  106. Santín-Rivero J, Núñez-García E, Aguirre-García M, Hagerman-Ruiz-Galindo G, de la Vega-González F, Moctezuma-Velasco CR. Intestinal volvulus. Case report and a literature review. Cir Cir. 2015;83(6):522–6.

    PubMed  Google Scholar 

  107. Abu-Zidan FM, Hefny AF, Saadeldinn YA, El-Ashaal YI. Sonographic findings of superior mesenteric artery syndrome causing massive gastric dilatation in a young healthy girl. Singap Med J. 2010;51:e184–6.

    CAS  Google Scholar 

  108. Nuño-Guzmán CM, Marín-Contreras ME, Figueroa-Sánchez M, Corona JL. Gallstone ileus, clinical presentation, diagnostic and treatment approach. World J Gastrointest Surg. 2016;8(1):65–76.

    PubMed  PubMed Central  Google Scholar 

  109. Ko YT, Lim JH, Lee DH, Yoon Y. Small bowel phytobezoars: sonographic detection. Abdom Imaging. 1993;18:271–3.

    CAS  PubMed  Google Scholar 

  110. Hosokawa T, Yamada Y, Sato Y, Tanami Y, Nanbu R, Hagiwara SI, Oguma E. Role of sonography for evaluation of gastrointestinal foreign bodies. J Ultrasound Med. 2016;35(12):2723–32.

    PubMed  Google Scholar 

  111. Lee DH, Lim JH, Ko YT. Afferent loop syndrome: sonographic findings in seven cases. AJR Am J Roentgenol. 1991;157:41–3.

    CAS  PubMed  Google Scholar 

  112. Danse E, Jamart J, Hoang P, et al. Focal bowel wall changes detected with colour Doppler ultrasound: diagnostic value in acute non-diverticular diseases of the colon. Br J Radiol. 2004;77:917–21.

    CAS  PubMed  Google Scholar 

  113. Danse EM, Van Beers BE, Jamart J, et al. Prognosis of ischemic colitis: comparison of color Doppler sonography with early clinical and laboratory findings. AJR Am J Roentgenol. 2000;175:1151–4.

    CAS  PubMed  Google Scholar 

  114. Ripolles T, Simo L, Martinez-Perez MJ, et al. Sonographic findings in ischemic colitis in 58 patients. AJR Am J Roentgenol. 2005;184:777–85.

    PubMed  Google Scholar 

  115. James V, Warier A, Lee KP, Ong GY-K. Point-of-care ultrasound identification of pneumatosis intestinalis in paediatric abdominal pain: a case report. Crit Ultrasound J. 2017;9:2.

    PubMed  PubMed Central  Google Scholar 

  116. Pan HB, Huang JS, Yang TL, Liang HL. Hepatic portal venous gas in ultrasonogram - Benign or noxious. Ultrasound Med Biol. 2007;33(8):1179–83.

    PubMed  Google Scholar 

  117. Roccarina D, Garcovich M, Ainora ME, Caracciolo G, Ponziani F, Gasbarrini A, Zocco MA. Diagnosis of bowel diseases: the role of imaging and ultrasonography. World J Gastroenterol. 2013;19(14):2144–53.

    PubMed  PubMed Central  Google Scholar 

  118. Dietrich CF, Jedrzejczyk M, Ignee A. Sonographic assessment of splanchnic arteries and the bowel wall. Eur J Radiol. 2007;64:202–12.

    CAS  PubMed  Google Scholar 

  119. Gebel M. Ultrasound in gastroenterology and hepatology. Berlin: Blackwell; 1999. p. 159–230.

    Google Scholar 

  120. Nazerian P, Tozzetti C, Vanni S, Bartolucci M, Gualtieri S, Trausi F, Vittorini M, Catini E, Cibinel GA, Grifoni S. Accuracy of abdominal ultrasound for the diagnosis of pneumoperitoneum in patients with acute abdominal pain: a pilot study. Crit Ultrasound J. 2015;7:15.

    PubMed  PubMed Central  Google Scholar 

  121. Seitz K, Reising KD. Ultrasound detection of free air in the abdominal cavity. Ultraschall Med. 1982;3:4–6.

    PubMed  Google Scholar 

  122. Muradali D, Wilson S, Burns PN, Shapiro H, Hope-Simpson D. A specific sign of pneumoperitoneum on sonography: enhancement of the peritoneal stripe. Am J Roentgenol. 1999;173:1257–62.

    CAS  Google Scholar 

  123. Karahan OI, Kurt A, Yikilmaz A, Kahriman G. New method for the detection of intraperitoneal free air by sonography: scissors maneuver. J Clin Ultrasound. 2004;32:381–5.

    PubMed  Google Scholar 

  124. Moriwaki Y, Sugiyama M, Toyoda H, Kosuge T, Arata S, Iwashita M, et al. Ultrasonography for the diagnosis of intraperitoneal free air in chest- abdominal- pelvic blunt trauma and critical acute abdominal pain. Arch Surg. 2009;144:137–41. discussion 42

    PubMed  Google Scholar 

  125. Numberg D, Mauch M, Spengler J, Holle A, Pannwitz H, Seitz K. Sonographical diagnosis of pneumoretroperitoneum as a result of retroperitoneal perforation. [in German. Ultraschall Med. 2007;28:612–21.

    Google Scholar 

  126. Wilson SP, Connolly K, Lahham S, et al. Point-of-care ultrasound versus radiology department pelvic ultrasound on emergency department length of stay. World J Emerg Med. 2016;7(3):178–82.

    PubMed  PubMed Central  Google Scholar 

  127. Thamburaj R, Sivitz A. Does the use of bedside pelvic ultrasound decrease length of stay in the emergency department? Pediatr Emerg Care. 2013;29(1):67–70.

    PubMed  Google Scholar 

  128. Mazzei MA, et al. The role of US examination in the management of acute abdomen. Crit Ultrasound J. 2013;5(Suppl 1):S6.

    PubMed  PubMed Central  Google Scholar 

  129. Kameda T, Kawai F, Taniguchi N, Kobori Y. Usefulness of transabdominal ultrasonography in excluding adnexal disease. J Med Ultrason. 2016;43(1):63–70.

    Google Scholar 

  130. Li XH, Ouyang Y, Lu GXT. value of transvaginal sonography in diagnosing heterotopic pregnancy after in-vitro fertilization with embryo transfer. Ultrasound Obstet Gynecol. 2013;41:563.

    CAS  PubMed  Google Scholar 

  131. Marks WM, Filly RA, Callen PW, Laing FC. The decidual cast of ectopic pregnancy: a confusing ultrasonographic appearance. Radiology. 1979;133:451–4.

    CAS  PubMed  Google Scholar 

  132. Benson CB, Doubilet PM, Peters HE, Frates MC. Intrauterine fluid with ectopic pregnancy: a reappraisal. J Ultrasound Med. 2013;32:389–93.

    PubMed  Google Scholar 

  133. Elson CJ, Salim R, Potdar N, Chetty M, Ross JA, Kirk EJ on behalf of the Royal College of Obstetricians and Gynaecologists. Diagnosis and management of ectopic pregnancy. BJOG 2016 123(13):e15-e55.

    Google Scholar 

  134. Nyberg DA, Hughes MP, Mack LA, Wang KY. Extrauterine findings of ectopic pregnancy of transvaginal US: importance of echogenic fluid. Radiology. 1991;178:823–6.

    CAS  PubMed  Google Scholar 

  135. Fleischer AC, Pennell RG, McKee MS, Worrell JA, Keefe B, Herbert CM, et al. Ectopic pregnancy: features at transvaginal sonography. Radiology. 1990;174:375–8.

    CAS  PubMed  Google Scholar 

  136. Dialani V, Levine D. Ectopic pregnancy: a review. Ultrasound Q. 2004;20(3):105.

    PubMed  Google Scholar 

  137. Stein JC, Wang R, Adler N, Boscardin J, Jacoby VL, Won G, et al. Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: a meta-analysis. Ann Emerg Med. 2010;56(6):674–83.

    PubMed  Google Scholar 

  138. Richardson A, Gallos I, Dobson S, Campbell BK, Coomarasamy A, Raine-Fenning N. Accuracy of first trimester ultrasound features for diagnosis of tubal ectopic pregnancy in the absence of an obvious extra-uterine embryo: a systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2015;47(1):28–37.

    PubMed  Google Scholar 

  139. Sohoni A, Bosley J, Miss JC. Bedside ultrasonography for obstetric and gynecologic emergencies. Crit Care Clin. 2014;30:207–26.

    PubMed  Google Scholar 

  140. Jain KA. Sonographic spectrum of hemorrhagic ovarian cysts. J Ultrasound Med. 2002;21:v879–86.

    Google Scholar 

  141. Amirbekian S, Hooley RJ. Ultrasound evaluation of pelvic pain. Radiol Clin N Am. 2014;52(6):1215–35.

    PubMed  Google Scholar 

  142. Lee EJ, Kwon HC, Joo HJ, et al. Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle. J Ultrasound Med. 1998;17(2):83–9.

    CAS  PubMed  Google Scholar 

  143. Cicardi M, Aberer W, Banerji A, et al. Classification, diagnosis, and approach to treatment for angioedema: consensus report from the Hereditary Angioedema International Working Group. Allergy. 2014;69:602–16.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. ASST Santi Paolo e Carlo, Milan, Italy

    Francesca Cortellaro

  2. ASST degli Spedali Civili di Brescia, Brescia, Italy

    Cristiano Perani

  3. ASST Dipartimento di Emergenza-Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Linda Guarnieri, Laura Ferrari, Michela Cazzaniga & Paolo Aseni

  4. Gastroenterology Unit, Department of Biomedical and Clinical Sciences, Luigi Sacco University Hospital, University of Milan, Milan, Italy

    Giovanni Maconi

  5. Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy

    Maddalena Alessandra Wu

Authors
  1. Francesca Cortellaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cristiano Perani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Linda Guarnieri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Laura Ferrari
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michela Cazzaniga
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giovanni Maconi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maddalena Alessandra Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Paolo Aseni
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Dipartimento di Emergenza Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Milano, Italy

    Paolo Aseni

  2. School of Medicine, University of Milano-Bicocca, Niguarda Hospital, Milan, Milano, Italy

    Luciano De Carlis

  3. Department of Cardiac Surgery, IRCCS MultiMedica, Milan, Milano, Italy

    Alessandro Mazzola

  4. Department of Cardiac Surgery, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy

    Antonino M. Grande

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Cite this chapter

Cortellaro, F. et al. (2019). Point-of-Care Ultrasound in the Diagnosis of Acute Abdominal Pain. In: Aseni, P., De Carlis, L., Mazzola, A., Grande, A.M. (eds) Operative Techniques and Recent Advances in Acute Care and Emergency Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-95114-0_27

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-95114-0_27

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-95113-3

  • Online ISBN: 978-3-319-95114-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation