Accuracy of point-of-care ultrasonography compared to abdominal X-ray in the diagnosis of small bowel obstruction in emergency patients

Background: Small bowel obstruction (SBO) is a common cause of acute abdominal pain. Many diagnostic modalities are used to diagnose or rule out SBO. Objective: This study aimed to compare the diagnostic accuracy of SBO for point-of-care ultrasound (POCUS) to that of abdominal X-ray (AXR) using comp...

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Bibliographic Details
Main Authors: Dina Saad Alsufyani, Sawsan Bagabas, Areej Alhamdi, Nawaf Basulaib, Maha Aleid, Ali Hasan Alkhulaif
Format: Article
Language:English
Published: Discover STM Publishing Ltd
Series:Saudi Journal of Emergency Medicine
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Online Access:https://sjemed.com/?mno=9278
Description
Summary:Background: Small bowel obstruction (SBO) is a common cause of acute abdominal pain. Many diagnostic modalities are used to diagnose or rule out SBO. Objective: This study aimed to compare the diagnostic accuracy of SBO for point-of-care ultrasound (POCUS) to that of abdominal X-ray (AXR) using computerized tomography (CT) and/or patients' follow-up as the gold standard. Methods: This was a prospective, cohort study of a convenience sample of adult patients, who presented to the emergency department (ED) with signs and symptoms suggestive of SBO. Emergency medicine residents performed POCUS looking for sonographic signs of SBO. Abdominal X-ray and CT results were based on the radiologist's final report. Results: A total of 77 patients were enrolled in the study. The mean age was 56 years, and the mean BMI was 28 kg/m2. Point-of-care ultrasound had a sensitivity of 90%, specificity of 61%, +likelihood ratio (LR) of 2.3, and -LR of 0.159, compared to AXR, which had a sensitivity of 57%, specificity of 62%, +LR of 1.5, and -LR 0.69. Conclusion: POCUS performed by ED residents for the diagnosis of SBO has high diagnostic accuracy as compared to that of AXR, with a p-value of 0.046. The accuracy is higher if all the sonographic signs are present or absent. [SJEMed 2022; 3(3.000): 181-186]
ISSN:1658-8487