Diagnostic Accuracy of Ultrasonography by Emergency Medicine Resident in Detecting Intestinal Obstruction; a Pilot Study
Archives of Academic Emergency Medicine,
Vol. 10 No. 1 (2022),
1 January 2022
,
Page e50
https://doi.org/10.22037/aaem.v10i1.1628
Abstract
Introduction: There are many ambiguities regarding the application of ultrasound in detection of intestinal obstruction. This study aimed to evaluate the diagnostic accuracy of ultrasound in diagnosis of intestinal obstruction.
Methods: This cross-sectional study was performed on patients with symptoms and signs of bowel obstruction between November19 and July 2020 in Shohadaye-Tajrish and Imam Hossein General Hospitals, Tehran, Iran. After a brief explanation and getting verbal consent, the patients underwent ultrasound examination in the emergency department by the emergency medicine resident. The results of ultrasound were compared with the surgical findings as the gold standard.
Results: 24 patients with the mean age of 57.50±18.26 (range: 28 – 81) years were studied (58.3% male). Ultrasonography findings revealed the lumen diameter ≥ 2.5 cm in 21 (87.5%) cases, wall thickness ≥ 3 mm in 3 (12.5%) cases and inter-loop free fluid in 3 (12.5%) cases. Sensitivity, positive predictive value, and accuracy of ultrasound in detection of intestinal obstruction were found to be 85.00% (95%CI: 61.13 – 96.03), 80.95% (95%CI: 57.42 – 93.71), and 70.83% (95%CI: 48.91 – 87.38), respectively.
Conclusion: It seems that point-of-care ultrasound has good sensitivity and accuracy in detection of intestinal obstruction when performed in the emergency department by a trained emergency medicine resident.
- Intestinal Obstruction
- Point-of-Care Testing
- Ultrasonography
- Emergency Service, Hospital
How to Cite
References
Catena F, De Simone B, Coccolini F, Di Saverio S, Sartelli M, Ansaloni L. Bowel obstruction: a narrative review for all physicians. World J Emerg Surg. 2019;14(1):1-8.
Jackson P, Cruz MV. Intestinal obstruction: evaluation and management. Am Fam Physician. 2018;98(6):362-7.
Pujahari AK. Decision making in bowel obstruction: a review. J Clin Diagn Res: JCDR. 2016;10(11):PE07.
Denham G, Smith T, James D, McKiernan S, Evans T-J. Exploring the evidence-practice gap in the use of plain radiography for acute abdominal pain and intestinal obstruction: a systematic review and meta-analysis. JBI Evidence Implementation. 2020;18(2):159-69.
Li Z, Zhang L, Liu X, Yuan F, Song B. Diagnostic utility of CT for small bowel obstruction: systematic review and meta-analysis. PloS one. 2019;14(12):e0226740.
Rosano N, Gallo L, Mercogliano G, Quassone P, Picascia O, Catalano M, et al. Ultrasound of Small Bowel Obstruction: A Pictorial Review. Diagnostics. 2021;11(4):617.
Tamburrini S, Lugarà M, Iaselli F, Saturnino PP, Liguori C, Carbone R, et al. Diagnostic accuracy of ultrasound in the diagnosis of small bowel obstruction. Diagnostics. 2019;9(3):88.
Tamburrini S, Serra N, Lugarà M, Mercogliano G, Liguori C, Toro G, et al. Ultrasound Signs in the Diagnosis and Staging of Small Bowel Obstruction. Diagnostics. 2020;10(5):277.
Rayat Dost E, Barazandehpour S, Kalani N, Abiri S. Painless aortic dissection with slurred speech (Neurologic symptom). Journal of Emergency Practice and Trauma. 2021;7(1):71-3.
Wang MQ, Lee MY, El Teo H. Ultrasound in the evaluation of necrotic bowel in children: A pictorial essay. Ultrasound. 2019;27(4):207-16.
Andrzejewska M, Grzymisławski M. The role of intestinal ultrasound in diagnostics of bowel diseases. Prz Gastroenterol. 2018;13(1):1.
Pourmand A, Dimbil U, Drake A, Shokoohi H. The Accuracy of Point-of-Care Ultrasound in Detecting Small Bowel Obstruction in Emergency Department. Emerg Med Int. 2018 Apr 4;2018:3684081. doi: 10.1155/2018/3684081. PMID: 29850250; PMCID: PMC5904810.
Ünlüer EE, Yavasi Ö, Eroglu O, Yilmaz C, Akarca FK. Ultrasonography by emergency medicine and radiology residents for the diagnosis of small bowel obstruction. Eur J Emerg Med. 2010;17(5):260-4.
Musoke F, Kawooya M, Miguli-Malwadde E. Comparison between sonographic and plain radiography in the diagnosis of small bowel obstruction at Mulago Hospital, Uganda. East Afr Med J 2003;80(10):540-5.
Jang TB, Schindler D, Kaji AH. Bedside ultrasonography for the detection of small bowel obstruction in the emergency department. Emerg Med J. 2011;28(8):676-8.
Ko YT, Lim JH, Lee DH, Lee HW, Lim JW. Small bowel obstruction: sonographic evaluation. Radiology. 1993;188(3):649-53.
Schmutz G, Benko A, Fournier L, Peron J, Morel E, Chiche L. Small bowel obstruction: role and contribution of sonography. Eur Radiol. 1997;7(7):1054-8.
Lin Y-C, Yu Y-C, Huang Y-T, Wu Y-Y, Wang T-C, Huang W-C, et al. Diagnostic accuracy of ultrasound for small bowel obstruction: A systematic review and meta-analysis. Eur J Radiol. 2021;136:109565.
Gottlieb M, Peksa GD, Pandurangadu AV, Nakitende D, Takhar S, Seethala RR. Utilization of ultrasound for the evaluation of small bowel obstruction: a systematic review and meta-analysis. Am J Emerg Med. 2018;36(2):234-42.
Taylor MR, Lalani N. Adult small bowel obstruction. Acad Emerg Med. 2013;20(6):527-44.
- Abstract Viewed: 803 times
- pdf Downloaded: 429 times
Download Statastics
Make a Submission
SJR
COPE
