Preoperative ultrasound to predict infraumbilical adhesions: a study of diagnostic accuracy.

Tu FF, Lamvu GM, Hartmann KE, Steege JF
Am J Obstet Gynecol. 2005 192 (1): 74-9

PMID: 15672006 · DOI:10.1016/j.ajog.2004.07.034

OBJECTIVE - The purpose of this study was to determine the test characteristics of preoperative abdominal ultrasound in predicting infraumbilical adhesions in women.

STUDY DESIGN - This was a diagnostic test study of 60 women at risk for intra-abdominal adhesions undergoing laparoscopy or vertical laparotomy. Participants underwent periumbilical sonographic measurement of visceral slide (longitudinal movement of the viscera during a cycle of respiration).

RESULTS - Prevalence of infraumbilical bowel adhesions was 12%. A visceral slide threshold <1 cm to predict adhesions had sensitivity = 86%, specificity = 91%, positive predictive value = 55%, and negative predictive value = 98%. On stratifying visceral slide (<0.8 cm, > or =0.8 and <1 cm, and > or =1 cm), the likelihood ratios for detecting adhesions were 15.1, 5.0, and 0.2, respectively.

CONCLUSION - Measuring visceral slide improves preoperative prediction of both presence and absence of bowel adhesions in patients with previous abdominal operations or infection; this technique may assist in avoiding iatrogenic bowel injury.

MeSH Terms (13)

Adult Cross-Sectional Studies Female Humans Laparoscopy North Carolina Peritoneal Diseases Predictive Value of Tests Preoperative Care Prevalence Sensitivity and Specificity Tissue Adhesions Ultrasonography

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