Article Text

other Versions

PDF
Bedside ultrasonography for the detection of small bowel obstruction in the emergency department
  1. Timothy B Jang1,2,
  2. Danielle Schindler1,
  3. Amy H Kaji2
  1. 1Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Olive View Medical Center and UCLA Medical Center, Torrance, California, USA
  2. 2Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center, Torrance, California, USA
  1. Correspondence to Timothy B Jang, Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Olive View Medical Center and UCLA Medical Center, 1000 W. Carson Street, D-9A, Torrance 90509, California, USA; tbj{at}ucla.edu

Abstract

Background Plain film radiography (x-ray) is often the initial study in patients with suspected small bowel obstruction (SBO) to expedite patient care.

Objective To compare bedside ultrasonography (US) and x-ray for the detection of SBO.

Methods This was a prospective study using a convenience sample of patients presenting to the emergency department (ED) with abdominal pain, vomiting, or other symptoms suggestive of a SBO. Patients were evaluated with US prior to x-ray and CT. US was performed by emergency physicians (EPs) who completed a 10 min training module and five prior US exams for SBO. The criterion standard for the diagnosis of SBO was the results of CT read by board-certified radiologists.

Results In all, 76 patients were enrolled and evaluated with US for SBO. A total of 33 (43%) were diagnosed as having SBO. Dilated bowel on US had a sensitivity of 91% (95% CI 75 to 98%) and specificity of 84% (95% CI 69 to 93%) for SBO, compared to 27% (95% CI 14 to 46%) and 98% (95% CI 86 to 100%) for decreased bowel peristalsis on US. x-Ray had a sensitivity of 46.2% (95% CI 20.4 to 73.9%) and specificity of 66.7% (95% CI 48.9 to 80.9%) for SBO when diagnostic, but was non-diagnostic 36% of the time.

Conclusion EP-performed US compares favourably to x-ray in the diagnosis of SBO.

  • Abdomen non-trauma
  • gastro-intestinal
  • imaging
  • ultrasound
  • Accepted 13 June 2010

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Olive View-UCLA Medical Center.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.