Accuracy of ultrasonography in the diagnosis of XXXX compared with the clinical impression of the surgeon.

@entity1 @entity298
HYPOTHESIS: Peritonitis is a well-known indication for surgery, but its preoperative cause usually is not established. We hypothesize that abdominal ultrasonography is superior to the clinical impression of the surgeon in detecting the cause of @entity298 . DESIGN: A prospective case series. SETTING: A major university hospital in Taiwan, Republic of China. @entity1 AND METHODS: One hundred two @entity1 with a diagnosis of @entity298 admitted to the Department of Emergency Medicine, National Taiwan University Hospital, Taipei, were included in this study. All 102 @entity1 underwent an abdominal ultrasonographic examination; and the ultrasonographic findings of these @entity1 were classified into 2 categories: positive findings and normal screening results. The accuracy of clinical impression in detecting the cause of @entity298 was compared with the accuracy of abdominal ultrasonography. RESULTS: Ultrasonography and clinical impression accurately diagnosed the @entity298 in 85 (83.3%) and 52 (51.0%) of the @entity1 , respectively. The difference between ultrasonography and clinical impression in the diagnosis of @entity298 was significant (P<.001). Among 45 @entity1 without a preoperative clinical diagnosis, a diagnosis was made by ultrasonography for 32 (71%) of them. There were a total of 98 @entity1 with positive ultrasonographic findings, and 4 @entity1 had normal screening results. Of the 98 @entity1 with positive ultrasonographic findings undergoing surgery, all had abdominal pathological characteristics. The 4 @entity1 with normal screening results received nonoperative treatment. CONCLUSIONS: Ultrasonography is a more sensitive technique than clinical judgment in diagnosing @entity298 . Ultrasonography may be a useful diagnosing modality in @entity1 with @entity298 in whom the clinical cause is unclear.
