abnormal bowel

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 ObstructionAcad Emerg Med. 2013;20:528-44