Small Bowel Obstruction
How does this stack up?
Sensitivity 92.4 %, Specificity 96.6% (comparable to CT), +LR of 27.5, -LR 0.08
Which probe?
Any can be used, but the curvilinear probe is ideal.
What am I looking for?
A large amount of fluid and echogenic material within the small bowel lumen, a to-and-fro or swirling motion of the luminal contents, KEYBOARD sign, TANGA sign
What are the numbers?
- Small bowel dilation > 2.5 - 3 cm
- Bowel wall thickening > 3 mm (ominous sign of possible ischemia/infarction)
Citations:
Gottlieb M, et al. Utilization of ultrasound for the evaluation of small bowel obstruction: a systematic review and meta-analysis. Am J Emerg Med. 2018; 36 (2): 234-242.
Jang TB, Schindler D, Kaji AH. Bedside ultrasonography for the detection of small bowel obstruction in the emergency department. Emerg Med J. 2011; 28: 676-678.
Taylor MR, Lalani N. Adult Small Bowel Obstruction. Acad Emerg Med. 2013;20:528-44