Quick-Look Sonography (QLS): A Useful Addition To The Physical Exam Of Patients With Non-Traumatic Abdominal Pain

Objectives: The purpose of this pilot study was to assess whether or not the use of four-view quick look sonography (QLS) by novice resident operators is a useful addition to the physical exam of patients presenting with non-traumatic abdominal pain. Methods: This was a retrospective review of patients presenting with non-traumatic abdominal pain who underwent QLS as part of their physical exam, prior to studies by the department of radiology or laparotomy. Results: 413 patients underwent QLS as part of their physical exam prior to department of radiology or operative evaluations. 55 residents performed QLS as part of their physical exam with an average of 6 QLS exams/resident (95% CI, 3-10) during the study period. Prior to the study period, no resident had performed more than five US exams. Results of resident QLS for free fluid (FF) are shown below. No patient with FF requiring operative management was missed by EP-QLS. 12 of 12 patients with hydronephrosis were correctly identified with resident-QLS. There was one false positive for hydronephrosis, yielding a sensitivity and specificity for hydronephrosis of 100% (95% CI, 69.9-100) and 99.8% (95% CI, 98.4-100). 5 of 6 patients with renal cysts were correctly diagnosed by resident-QLS. There were no false positives for renal cyst, corresponding to a sensitivity and specificity for renal cysts of 83.3% (95% CI, 36.5-99.1) and 100% (95% CI, 98.8-100). Other abdominal findings of QLS are shown below. Conclusion: QLS by novice resident operators appears to be a useful addition to the physical exam in evaluating patients presenting with non-traumatic abdominal pain. This is an aspect of the physical exam that is worthy of future studies.