Ultrasound demonstration of radiographically obscure small bowel obstruction

Ms, Pon; Scudamore, Charles H.; Rc, Harrison; Pl, Cooperberg

doi:10.2214/ajr.133.1.145

Cited by 10 publications

(4 citation statements)

References 2 publications

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“…Abdominal POCUS is widely used as a clinical tool for the management and diagnosis of patients with abdominal pathology [144][145][146][147][148]. Evaluation of free fluid is particularly useful when sudden clinical deterioration and hypotension occur and may provide insight into the ongoing pathophysiologic process [149,150] A renal ultrasound is useful to easily detect the presence of hydronephrosis even by novices [152][153][154]. Urinary retention can be evaluated by POCUS assessing postvoid residual volumes.…”

Section: Pocus-guided Technique Is Helpful Formentioning

confidence: 99%

International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

et al. 2020

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Background: Point-of-care ultrasound (POCUS) is nowadays an essential tool in critical care. Its role seems more important in neonates and children where other monitoring techniques may be unavailable. POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) aimed to provide evidence-based clinical guidelines for the use of POCUS in critically ill neonates and children. Methods: Creation of an international Euro-American panel of paediatric and neonatal intensivists expert in POCUS and systematic review of relevant literature. A literature search was performed, and the level of evidence was assessed according to a GRADE method. Recommendations were developed through discussions managed following a Quaker-based consensus technique and evaluating appropriateness using a modified blind RAND/UCLA voting method. AGREE statement was followed to prepare this document. Results: Panellists agreed on 39 out of 41 recommendations for the use of cardiac, lung, vascular, cerebral and abdominal POCUS in critically ill neonates and children. Recommendations were mostly (28 out of 39) based on moderate quality of evidence (B and C). Conclusions: Evidence-based guidelines for the use of POCUS in critically ill neonates and children are now available. They will be useful to optimise the use of POCUS, training programs and further research, which are urgently needed given the weak quality of evidence available.

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Section: Pocus-guided Technique Is Helpful Formentioning

confidence: 99%

International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

et al. 2020

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“…Bereits 1979 wurde tiber sonographische Darstellung distendierter Dtinndarmschlingen berichtet und anhand von vier Fallen auf den Wert der Ultraschall-Diagnostik bei "gasfreien Abdomen" wegen Strangulationsileus hingewiesen [8]. In der Foige kamen tiberwiegend Fallberichte hinzu [9][10][11][12][13][14] . Daruber hinaus sind bis heute nur relativ wenige weitere Arbeiten zur sonographischen Ileusdiagnostik verfiigbar [15 -17], darunter nur eine einzige prospektive Arbeit von Meiser et al [18] an 48 Patienten.…”

Section: Klinik Und Pathophysiologieunclassified

“…Es gilt daher in der klinischen Routine der Sonographie den ihr zukommenden Stellenwert als unverzichtbares additives, wiederholt anwendbares bildgebendes Verfahren nach der klinischen Untersuchung -neben der Rontgendiagnostik -zu verschaffen. Insbesondere ist viel zu wenig bekannt, welch ergiebiges Feld die Sonographie beim akuten "gasfreien" Abdomen darstellt, woraus sich die Indikation zu ihrem fruhzeitigen Einsatz ableitet [4,8,10,12,14] . 1m Zeitalter der "evidenced based medicine" wurde die sonographische Akzeptanz der Sonographie durch prospektive Untersuchungen zur Ileusdiagnostik wesentlich erhoht, wenngleich, wie gezeigt, aile diagnostischen Fakten bereits bekannt sind.…”

Section: Klinik Und Pathophysiologieunclassified

Sonographische Ileusdiagnostik

Seitz¹,

Merz²

2008

Ultraschall in Med

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Bowel obstruction is an acute alarming situation with limited diagnostic conditions. Therapeutic decisions must be taken in time. Diagnostic differentiation between incomplete or complete bowel obstruction, intestinal obstruction and paralytic ileus is often uncertain and the underlying cause difficult to detect. Besides plain films in acute abdomen the ultrasound examination presents important additional informations: 1st Dilated intestinal loops and gas caps correlate with the characteristic x-ray finding, i.e. erected dilated intestinal loops with fluid levels. The location of the obstruction is defined in small bowel obstruction by differentiation between jejunum (with Kerckring folds) and ileum (without Kerckring folds). In large bowel obstruction the caecum is dilated and a collapse of the distal colon is detectable. 2nd Additional sonographical findings are: oedema of the intestinal walls, hyperpendulum peristalsis or absence of peristalsis, sedimentation of intestinal contents, pearlstring-like lined up gas bubbles under the ventral intestinal walls, and concomitant ascites. Duplex sonographical studies of the intestinal peristalsis may help to differentiate between mechanical obstruction and paralytic ileus. 3rd In bowel obstruction stenoses can be detected as a result of tumour, Crohn's disease diverticulitis, invagination, strangulated hernias or gall stone ileus. Intestinal adhesions cannot be found by ultrasound. Small and large bowel is dilated in paralytic ileus. Numerous causes like acute pancreatitis, ureteral colic, free gastrointestnal perforation and so on can be diagnosed. 4th In ileus of vascular disorder early diagnosis is high important, but inspite of colour flow imaging diagnostic possibilities are limited. 5th Sonographical diagnosis is of special interest when the x-ray plain films is "empty". The lack of massive fluid collection and meteorism allows an optimal ultrasound examination. In this early phase disorders of peristalsis and intestinal walls are reliably found, and it is easier to find the cause of bowel obstruction. In this way the definitive diagnosis can be arrived at earlier, because it still takes up to 6 hours to obtain the classical x-ray finding. There is a rule that the earlier ultrasound is done, the more findings one will get.

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“…Ultrasound for SBO was first described in case series during the 1970s and has been shown to be both sensitive and specific in subsequent studies . The ability of POCUS to accurately diagnose SBO could potentially improve patient care by decreasing time to diagnosis and expediting consultation, as seen with other POCUS applications .…”

Section: Introductionmentioning

confidence: 99%

A Prospective, Multicenter Evaluation of Point‐of‐care Ultrasound for Small‐bowel Obstruction in the Emergency Department

Becker

Lahham

Gonzales

et al. 2019

Academic Emergency Medicine

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Objective:The main objective of this study was to evaluate the accuracy of emergency physician-performed point-of-care ultrasound (POCUS) for the diagnosis of small-bowel obstruction (SBO) compared to computed tomography (CT). Methods:We performed a prospective, multicenter, observational study examining a convenience sample of adult patients with potential SBO presenting to the emergency department (ED) between July 2014 and May 2017. Each POCUS was interpreted at the bedside by the performing emergency physician and retrospectively by an expert reviewer. Test characteristics were calculated for POCUS, blinded expert interpretation, and specific POCUS parameters.From the

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Ultrasound demonstration of radiographically obscure small bowel obstruction

Cited by 10 publications

References 2 publications

International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

Sonographische Ileusdiagnostik

A Prospective, Multicenter Evaluation of Point‐of‐care Ultrasound for Small‐bowel Obstruction in the Emergency Department

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