Validation of abdominal ultrasound examination for assessment of abdominal wall thickness and size of left lobe of liver in morbidly obese patients in comparison with CT and operative findings

Abstract Background Increased abdominal wall thickness and size of left lobe of liver affect the ergonomics of bariatric surgery increasing its difficulty and leading to need of special preparations such as extra-long instruments. Computed tomography (CT) abdomen is the gold standard modality in assessment of abdominal wall thickness and size of left lobe of liver, but it has many drawbacks such as radiation and contrast. In this study, we validate ultrasound as an alternative to CT by comparing its results with CT abdomen and operative findings. Results Abdominal ultrasound examination gives accurate results in assessment of anterior abdominal wall thickness and size of left lobe of liver in morbidly obese patients compared to CT and intra-operative with slight difference between values which is clinically accepted. Accuracy of ultrasound examination was 78.6%, 74.1%, and 100% for midline measurements, midclavicular line measurements and size of lt lobe of liver measurements, respectively. Ultrasound examination has sensitivity of 75%, 66.7% and 63.2% for midline measurements, midclavicular line measurements and size of lt lobe of liver measurements, respectively. Ultrasound examination specificity was 50%, 77.1% and 75.3% for midline measurements, midclavicular line measurements and size of lt lobe of liver measurements, respectively. Conclusion Abdominal ultrasound examination is a valid method in preoperative assessment of anterior abdominal wall thickness and size of left lobe of liver in morbidly obese patients. It is reliable, easy, and cheap and avoids drawbacks of CT.