195 Use of Abdominal Ultrasound Scans in Surgical Assessment Unit

Aim Abdominal ultrasound scan is one of the most common scans performed in general surgery. It is relatively cheaper, faster, and safer than most of the other imaging modalities. However, inappropriate use of abdominal ultrasound scans can lead to delay in diagnosis, unnecessary hospital admission and extended length of stay, which could induce stress in patients. This study aims to evaluate the need and usefulness of abdominal ultrasound scans performed for patients complaining of abdominal pain in SAU. Method A 1-month snapshot retrospective case note review of patients that presented to SAU with abdominal pain and underwent subsequent abdominal ultrasound scans. Variables included presenting complaint, working diagnosis, ultrasound findings, and outcome data. Scans were categorised into normal and abnormal. Abnormal was further sub-categorised into positive for diagnostic question, and positive for other diagnosis. Results Of the 522 patients that presented to SAU with abdominal pain, 87 had abdominal ultrasound scans. Of these 87 patients, lower (52%) and upper abdominal pain (40%) were the most common presenting complaints. The most common working diagnoses were pathologies of the biliary (41%) and gynaecological (40%) systems. There were 16 abnormal scans, of which the 10 were positive for the diagnostic question. Ten patients required subsequent MR or CT scan and 5 patients required hospital admission. Conclusions Most scans were performed to rule out acute surgical pathologies and for reassurance purposes. To reduce the number of abdominal ultrasound scans performed, we created a standard operating procedure flowsheet that will help determine patients to be scanned based on clinical presentations.