الفهرس 
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Abstract
This cross-sectional study was carried out in the Department of Obstetrics and
Gynecology at Menoufia University Hospitals in the period between January and
October 2019. The study involved 151 participants who were planned for gynecologic
surgeries, laparoscopic and open for different indications.
All of participants had a preoperative visceral slide test for screening of intraabdominal adhesions that were suspected when visceral movement was restricted. So,
the test was described as positive with restriction of visceral movement < 3cm and
described as negative with normal visceral movement ≥ 3cm during exaggerated
respiration. The abdomen was examined for the presence of visceral slide in five
predefined zones: right upper quadrant (RUQ), right lower quadrant (RLQ), left upper
quadrant (LUQ), left lower quadrant (LLQ), and umbilical zone. The umbilical zone is
defined as an area with a 5-cm radius, centred on the umbilicus. The test detected 45
cases with restricted visceral slide (positive for adhesion) and 106 cases with normal
visceral slide (negative for adhesions) the median time of doing the test is 3.5 min.
Then all of the participants underwent gynecologic surgery after doing the
visceral slide test to assess the presence or absence of intraperitoneal adhesions.
Procedures were done; 92 hysterectomies, 26 laparoscopies, 19 explorations, 13
myomectomies and one abdominal sling. After a successful entry into the peritoneal
cavity either by laparoscopy or by laparotomy, operative findings (as regard peritoneal
adhesions whether no, mild or marked adhesions) together with the operative
complications (visceral injury) were recorded by the gynecologic surgeon who was
blinded to the results of the ultrasonography. Intraperitoneal adhesions were classified
into four grades using peritoneal adhesion index (PAI). Adhesions were diagnosed
intra-operatively in 52 cases, 28 of them were filmy adhesions, 15 were dense and 9
were very dense adhesions.
Then the sonographic findings (sliding sign) were correlated to the corresponding
operative findings (peritoneal adhesions) for each patient to evaluate the diagnostic
value & accuracy of ultrasonographic sliding sign to predict intra-abdominal adhesions
in patients scheduled for gynecologic surgery.
The test showed a sensitivity of 78.85%, specificity of 95.96%, PPV of 91.11%,
NPV of 89.62% and overall diagnostic accuracy of 90.07%.