Document Detail

Factors predicting significant pathology on ultrasonography in women presenting with non-specific lower abdominal pain.
MedLine Citation:
PMID:  22507717     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Ultrasonography is used frequently to exclude significant pathology in young women presenting with non-specific lower abdominal pain (NSLAP). This study examined parameters that predicted the likelihood of significant findings on ultrasonography. These results could be used to select patients for priority imaging or identify those who could be managed with no ultrasonography.
METHODS: A total of 65 women with NSLAP were identified from 283 admissions. Group 1 (n=42) consisted of patients with normal imaging. Group 2 (n=23) included patients with 'positive' scans requiring treatment. White cell count (WCC), C-reactive protein (CRP) levels, platelet count, age, duration of pain and length of stay in hospital were compared between the groups.
RESULTS: The median WCC and CRP were greater in Group 2 than in Group 1: 15 x 10(9)/l and 123 mg/l versus 11 x 10(9)/l and 72 mg/l respectively (p=0.01 and p=0.05). CRP was a weak predictor of positive pathology on ultrasonography (area under curve [AUC]=0.66, p=0.027) and WCC was a strong predictor of abnormal pathology on ultrasonography (AUC=0.7, p=0.005). A WCC of >12.8 x 10(9)/l was 65% sensitive and 71% specific in predicting subsequent pathology on ultrasonography. The median wait for ultrasonography was 24 hours (range: 1-96 hours).
CONCLUSIONS: This study failed to define any criteria that could select patients not requiring ultrasonography. Since ultrasonography is a relatively cheap and safe investigation, its continued use to screen women with NSLAP is justified. WCC should be used to prioritise imaging.
D K Bilku; T C Hall; A R Dennison; M S Metcalfe; G Garcea
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  94     ISSN:  1478-7083     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-17     Completed Date:  2012-06-21     Revised Date:  2013-07-31    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  England    
Other Details:
Languages:  eng     Pagination:  155-8     Citation Subset:  IM    
University Hospitals of Leicester NHS Trust, UK.
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MeSH Terms
Abdominal Pain / etiology,  ultrasonography*
Aged, 80 and over
C-Reactive Protein / metabolism
Length of Stay
Leukocyte Count
Middle Aged
Prospective Studies
ROC Curve
Young Adult
Reg. No./Substance:
9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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