GI

Diagnostic Accuracy of Ultrasound in the Diagnosis of Small Bowel Obstruction

Stefania Tamburrini 1,* , Marina Lugarà 2, Francesco Iaselli 1, Pietro Paolo Saturnino 1, Carlo Liguori 1, Roberto Carbone 1, Daniela Vecchione 1, Roberta Abete 3, Pasquale Tammaro 3 and Ines Marano

05/13/2020

Article: https://www.ncbi.nlm.nih.gov/pubmed/31390727

Reviewer: Ludwig Koeneke-Hernandez

Design: Retrospective single-center cohort study comparing the accuracy of ultrasound in diagnosing and staging SBO as compared to the gold standard of the CT scan.

Limitations:

Small sample study

Single center study

Practice changing?

Yes

Take home point - Ultrasound is highly accurate in the diagnosis of SBO and improves patient care by decreasing time to diagnosis and expediting consultation and disposition of these potentially rapidly deteriorating patients

11/30/18

Reviewer: Dr. Paul Eugene

Article: http://www.wjem.com.cn/default/articlef/index/id/648

Retrospective, single-center cohort study in a large tertiary academic center performed to evaluate the accuracy of POCUS compared to abdominal CT in the assessment of patients by a variety of providers with suspected small bowel obstruction.

Limitations:

- Small sample size

- Data was obtained from a retrospective chart review in a single-center cohort

- Providers involved in the study had varied experience levels with point-of-care abdominal ultrasonography and 13% of the ultrasounds performed were deemed "indeterminate" by the performing provider

- Because most of the patients diagnosed in the study site's ED have active cancer, the patient population may not be generalizable to other emergency departments

- Selection bias may have occurred because not every patient with suspected SBO at the site's ED receives abdominal ultrasound prior to CT

- Determination of which patients undergo POCUS is based on several factors including

Practice changing? - It depends. In a certain patient population this could be a very useful application of POCUS. In particular, those patients with a known prior history of small bowel obstruction who have had multiple admissions with subsequent CT scan in the recent past.

Take home point - Ultrasound can play an important role in the identification of SBO in a select population of ED patients.

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