Acute abdominal pain. Actual surgical aspects of sonography.

The results of a prospective study show the most common causes of acute abdominal pain, and the diagnostic role of sonography in such cases is evaluated. Sonography performs three significant functions: visualization of pathologically changed organs, identification of healthy organs, and ultrasound-guided puncture of intra-abdominal collections of fluid. Affections in the right upper quadrant can be best diagnosed sonographically. Edematous pancreatitis can be easily identified; interpretation is difficult, however, in the presence of necrosis and abscesses. Therefore, computed tomography is also necessary. Sonography can differentiate between a mechanical and a paralytic ileus, but radiological examination is still necessary. In inflammatory diseases of the gastrointestinal tract, sonography may be helpful for diagnosis. An aortic aneurysm can be easily identified, whereas mesenteric infarction cannot. In the future, however, the use of a duplex scan may help in recognizing this condition. Affections of the abdominal wall can be visualized well by using a high-frequency transducer.