Yiming Gao MD, Presenter: Nothing to Disclose

Karen Sisi Lee MD, Abstract Co-Author: Nothing to Disclose

Marc A. Camacho MD, MS, Abstract Co-Author: Nothing to Disclose

The purpose of this retrospective study was to determine the diagnostic value of a pelvic sonogram performed following a negative abdominal and pelvic CT exam in female patients presenting to the emergency room with abdominal and/or pelvic pain, and whether the ultrasound altered acute clinical management in the emergency room setting.

This HIPAA-compliant retrospective study was approved by the institutional review board. Informed consent was waived. Between January 2005 to October 2010, 134 consecutive non-pregnant female patients presented to the emergency room with abdominal and/or pelvic pain who underwent a pelvic sonogram within 24 hours following an abdominal and pelvic CT exam interpreted as negative for acute pathology. The imaging findings and reports for the CT and ultrasound exams, patient demographics, clinical and laboratory data, and clinical outcomes were recorded. The waiting time between the performance of the CT scan and subsequent ultrasound was also calculated.

Pelvic sonograms were performed in 134 women with a mean age of 32 years (range, 21-70 years) following negative abdominal and pelvic CT exams in the emergency room. Of the 134 ultrasound exams, 130 (97%) were interpreted as normal. Four (3%) of 134 sonograms yielded positive findings, all of which were endometrial abnormalities. One of these four patients was ultimately diagnosed with endometrial polyp, while the other three patients were lost to follow-up. In none of the four cases did the pelvic ultrasound findings add diagnostic information pertaining to the acute presentation or alter clinical management within the emergency room setting. The average wait time from the performance of the CT scan to the ultrasound scan was 3 hours and 4 minutes.

In the setting of acute care, a pelvic ultrasound following a negative abdominal and pelvic CT exam in female patients presenting with abdominal and/or pelvic pain does not add diagnostic value, and does not alter patient management.

The results may alter ordering practice patterns in our emergency room for women presenting with pelvic pain, eliminate unnecessary sonograms following normal CT studies, and decrease length of stay.

Gao, Y, Lee, K, Camacho, M, Utility of Pelvic Ultrasound Following Negative Abdominal and Pelvic CT in the Emergency Room.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11006145.html