Peter Grubel1. 1. Borland-Groover Clinic, Ormond Beach, FL 32174, USA. pgrubel01@bgclinic.com
Abstract
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.
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.