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Surgeon-Performed Point-of-Care Ultrasound in the Diagnosis of Acute Sigmoid Diverticulitis: A Pragmatic Prospective Multicenter Cohort Study.

dc.contributor.authorDumbrava, Bogdan D
dc.contributor.authorAbdulla, Hajar S
dc.contributor.authorPereira, Jorge
dc.contributor.authorBiloslavo, Alan
dc.contributor.authorZago, Mauro
dc.contributor.authorHashem, Jamal H
dc.contributor.authorKumar, Nitya
dc.contributor.authorCorbally, Martin
dc.contributor.authorBass, Gary A
dc.contributor.authorWalsh, Thomas N
dc.date.accessioned2024-07-22T15:43:46Z
dc.date.available2024-07-22T15:43:46Z
dc.date.issued2023-01-03
dc.identifier.issn2168-8184
dc.identifier.pmid36741667
dc.identifier.doi10.7759/cureus.33292
dc.identifier.urihttp://hdl.handle.net/10147/642415
dc.descriptionBackground and purpose Early diagnosis and risk stratification of sigmoid diverticulitis rely heavily on timely imaging. Computerized tomography (CT), the gold standard diagnostic test, may be delayed due to resource constraints or patient comorbidity. Point-of-care ultrasound (POCUS) has an established role in trauma evaluation, and could potentially diagnose and stage acute diverticulitis, thus shortening the time to definitive treatment. Aims This study aimed to benchmark the accuracy of surgeon-performed POCUS against CT in diagnosing and staging acute diverticulitis. A secondary aim was to evaluate the duration between the POCUS and the confirmatory CT scan report. Patients and methods A pragmatic prospective multicenter cohort study (ClinicalTrials.gov Identifier: NCT02682368) was conducted. Surgeons performed point-of-care ultrasound as first-line imaging for suspected acute diverticulitis. POCUS diagnosis and radiologic Hinchey classification were compared to CT as the reference standard. Results Of 45 patients with suspected acute diverticulitis, POCUS classified 37 (82.2%) as uncomplicated diverticulitis, four (8.8%) as complicated diverticulitis, and four (8.8%) as other diagnoses. The POCUS-estimated modified radiologic Hinchey classification was largely concordant with CT staging with an accuracy of 88.8% (95% CI, 75.95-96.2%), a sensitivity of 100% (95% CI, 90.2- 100%) and a specificity of 44.4% (95% CI, 13.7-78.8%). The positive predictive value (PPV) was 87.8% and the negative predictive value (NPV) was 100%. There was moderate agreement between CT and POCUS, with a Cohen's kappa coefficient of 0.56. The mean delay between CT and POCUS was 9.14 hours (range 0.33 to 43.5). Conclusion We examined the role of POCUS in the management of acute diverticulitis and our findings suggest that it is a promising imaging modality with the potential to reduce radiation exposure and treatment delays. Adding a POCUS training module to the surgical curriculum could enhance diagnosis and expedite the management of acute diverticulitis.en_US
dc.language.isoenen_US
dc.rightsCopyright © 2023, Dumbrava et al.
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectabdominal sonographyen_US
dc.subjectacute abdomenen_US
dc.subjectdiverticulitisen_US
dc.subjectPoCUSen_US
dc.subjectultrasounden_US
dc.titleSurgeon-Performed Point-of-Care Ultrasound in the Diagnosis of Acute Sigmoid Diverticulitis: A Pragmatic Prospective Multicenter Cohort Study.en_US
dc.typeArticleen_US
dc.identifier.journalCureusen_US
dc.source.journaltitleCureus
dc.source.volume15
dc.source.issue1
dc.source.beginpagee33292
dc.source.endpage
refterms.dateFOA2024-07-22T15:43:49Z
dc.source.countryUnited States


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Copyright © 2023, Dumbrava et al.
Except where otherwise noted, this item's license is described as Copyright © 2023, Dumbrava et al.