Accuracy of Ultrasonography for the Diagnosis of Pneumoperitoneum in the Emergency Department

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT02004925

Enrollment

Registered

2013-12-09

Start date

2014-01-31

Completion date

2014-09-30

Last updated

2015-04-24

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Pneumoperitoneum

Keywords

pneumoperitoneum, free peritoneal air, ultrasonography

Brief summary

Pneumoperitoneum could be due to life threatening conditions and its quickly diagnosis is important in the emergency department (ED). Signs and symptoms are non-specific and radiography has low accuracy in the acute setting. Computed tomography (CT) is considered the gold standard, however it is not a cost-effective option in the vast population of patients with abdominal pain. Ultrasonography is able to detect as little as 2 ml of free air, however diagnostic accuracy of ultrasonography remains unclear. This study evaluates the accuracy of ultrasonography for the diagnosis of pneumoperitoneum, the most accurate abdominal scan and the most accurate echographic sign for the detection of free air. Methods Consecutive patients presenting to ED for acute abdominal pain and with a diagnosis of pneumoperitoneum at CT or at surgery (study group) and a similar number of patients without a diagnosis of pneumoperitoneum (control group) undergo abdominal ultrasonography in a standardized protocol that include 10 scans for each patient registered on a video of 5 seconds. The videos are randomly reviewed by 4 sonographers and by 2 physicians with no experience in ultrasonography blind to final diagnosis and to all clinical data with the aim of detecting for each scan pneumoperitoneum. Accuracy of ultrasonography for the diagnosis of pneumoperitoneum will be calculated considering CT or surgery as gold standard. Furthermore intra and interobserver agreement and the accuracy of each ultrasonographic sign and scan will be calculated.

Interventions

None listed

Study design

Observational model

CASE_CONTROL

Time perspective

CROSS_SECTIONAL

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* All patients more than 18 years with acute abdominal pain

Exclusion criteria

* Refused consent * Less than 18 years old * Not possible to perform ultrasonography

Design outcomes

Primary

Measure	Time frame	Description
Accuracy of ultrasonography for the diagnosis of pneumoperitoneum	No follow-up for the included patients. Outcome is measured one month after the end of recruitment	CT or surgery are considered the gold standard for the diagnosis of pneumoperitoneum

Secondary

Measure	Time frame
Accuracy of each scan and of each sonographic sign for the diagnosis of pneumoperitoneum	No follow-up for the included patients. Outcome is measured one month after the end of recruitment

Other

Measure	Time frame	Description
Inter and intraobserver agreement between reviewers	No follow-up for the included patients. Outcome is measured one month after the end of recruitment	Concordance between the reviewers of the ultrasonographic videos for pneumoperitoneum diagnosis

Countries

Italy

Outcome results