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Diagnostics (Basel). 2019 Aug 6;9(3). pii: E88. doi: 10.3390/diagnostics9030088.

Diagnostic Accuracy of Ultrasound in the Diagnosis of Small Bowel Obstruction.

Author information

1
Department of Radiology, Ospedale del Mare-ASLNa1 Centro, 80147 Napoli, Italy. tamburrinistefania@gmail.com.
2
Department of Internal Medicine, Ospedale del Mare-ASLNa1 Centro, 80147 Napoli, Italy.
3
Department of Radiology, Ospedale del Mare-ASLNa1 Centro, 80147 Napoli, Italy.
4
Department of General Surgery, Ospedale del Mare-ASLNa1 Centro, 80147 Napoli, Italy.

Abstract

INTRODUCTION:

Small bowel obstruction (SBO) is a common presentation to the Emergency Department (ED). This study aimed to analyze the accuracy of ultrasound (US) in diagnosing and staging SBO.

OBJECTIVES:

The main object of this study was to analyze the accuracy of ultrasound in diagnosing and staging SBO compared to CT.

METHODS:

Retrospectively, stable patients with an ultrasonographic diagnosis of SBO who underwent abdominal CT immediately after US and before receiving naso-intestinal decompression, were included. US criteria for the diagnosis of SBO were related to morphological and functional findings. US diagnosis of obstruction was made if fluid-filled dilated small bowel loops were detected, peristalsis was abnormal and parietal abnormalities were present. Morphologic and functional sonographic findings were assigned to three categories: simple SBO, compensated SBO and decompensated SBO. US findings were compared with the results of CT examinations: Morphologic CT findings (divided into loop, vascular, mesenteric and peritoneal signs) allowed the classification of SBO in simple, decompensated and complicated.

RESULTS:

US diagnostic accuracy rates in relation to CT results were calculated: ultrasound compared to CT imaging, had a sensitivity of 92.31% (95% CI, 74.87% to 99.05%) and a specificity of 94.12% (95% CI, 71.31% to 99.85%) in the diagnosis of SBO.

CONCLUSIONS:

This study, similarly to the existing literature, suggests that ultrasound is highly accurate in the diagnosis of SBO, and that the most valuable sonographic signs are the presence of dilated bowel loops ad abnormal peristalsis.

KEYWORDS:

abdominal ultrasound; bedside ultrasound; bowel ultrasound; emergency ultrasound; point of care ultrasound; small bowel obstruction

PMID:
31390727
DOI:
10.3390/diagnostics9030088
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