24 - Abdominal Ultrasound

Summary

INDICATION

Abdominal ultrasound has become an extremely useful imaging modality in emergency medicine. In combination with CT, abdominal ultrasound can diagnose many of the disease processes that must be identified by the emergency physician. Ultrasound has several advantages that make it ideal for use in the ED — most notably, that it is portable and hence can be done at the bedside in an unstable patient. In addition, other advantages that it has over CT are that it does not require an oral preparation, so it can be done immediately, does not expose the patient to ionizing radiation, and does not involve the risks inherent to intravenous contrast, such as in patients with iodine allergies and renal failure.

Many of the common indications for abdominal ultrasound, such as right upper quadrant pain, flank pain, trauma, and evaluation of the aorta, are covered elsewhere. However, there are several other unique disease entities that can be diagnosed with abdominal ultrasound and with which the emergency physician should be familiar.

DIAGNOSTIC CAPABILITIES

Gastrointestinal Tract

Acute Appendicitis

Acute appendicitis can be diagnosed with ultrasound and is the preferred initial imaging modality by some clinicians for certain populations, such as in pregnant patients, to avoid ionizing radiation (1,2).