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
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.
Small sample study
Single center study
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
Reviewer: Dr. Paul Eugene
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.
- 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.