Accuracy of point-of-care ultrasonography compared to abdominal X-ray in the diagnosis of small bowel obstruction in emergency patients
Authors:
Dina Saad Alsufyani,
Sawsan Bagabas,
Areej Alhamdi,
Nawaf Basulaib,
Maha Aleid,
Ali Hasan Alkhulaif
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.
Keywords: Point-of-care ultrasound, small bowel obstruction, emergency ultrasound, bedside ultrasound.
Authors
Ali Hasan Alkhulaif
Consultant of Emergency Medicine, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
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Correspondence to:
Ali Hasan Alkhulaif, Consultant of Emergency Medicine, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia ahalkhulaif@kaauh.edu.sa
Publication history:
Received 04 Apr 2022
Revised 11 May 2022
Accepted 01 Jun 2022
Published online 15 Jun 2022
Published in print 01 Dec 2022
Alsufyani DS, Bagabas S, Alhamdi A, Basulaib N, Aleid M, Alkhulaif AH. Accuracy of point-of-care ultrasonography compared to abdominal X-ray in the diagnosis of small bowel obstruction in emergency patients. SJEMed. 2022; 3(3): 181-186. doi:
10.24911/SJEMed/72-1649057029
Alsufyani DS, Bagabas S, Alhamdi A, Basulaib N, Aleid M, Alkhulaif AH. Accuracy of point-of-care ultrasonography compared to abdominal X-ray in the diagnosis of small bowel obstruction in emergency patients. https://sjemed.com/?mno=9278 [Access: October 31, 2024]. doi:
10.24911/SJEMed/72-1649057029
Alsufyani DS, Bagabas S, Alhamdi A, Basulaib N, Aleid M, Alkhulaif AH. Accuracy of point-of-care ultrasonography compared to abdominal X-ray in the diagnosis of small bowel obstruction in emergency patients. SJEMed. 2022; 3(3): 181-186. doi:
10.24911/SJEMed/72-1649057029
Alsufyani DS, Bagabas S, Alhamdi A, Basulaib N, Aleid M, Alkhulaif AH. Accuracy of point-of-care ultrasonography compared to abdominal X-ray in the diagnosis of small bowel obstruction in emergency patients. SJEMed. (2022), [cited October 31, 2024]; 3(3): 181-186. doi:
10.24911/SJEMed/72-1649057029
Alsufyani, D. S., Bagabas, . S., Alhamdi, . A., Basulaib, . N., Aleid, . M. & Alkhulaif, . A. H. (2022) Accuracy of point-of-care ultrasonography compared to abdominal X-ray in the diagnosis of small bowel obstruction in emergency patients. SJEMed, 3 (3), 181-186. doi:
10.24911/SJEMed/72-1649057029
Alsufyani, Dina Saad, Sawsan Bagabas, Areej Alhamdi, Nawaf Basulaib, Maha Aleid, and Ali Hasan Alkhulaif. 2022. Accuracy of point-of-care ultrasonography compared to abdominal X-ray in the diagnosis of small bowel obstruction in emergency patients. Saudi Journal of Emergency Medicine, 3 (3), 181-186. doi:
10.24911/SJEMed/72-1649057029
Alsufyani, Dina Saad, Sawsan Bagabas, Areej Alhamdi, Nawaf Basulaib, Maha Aleid, and Ali Hasan Alkhulaif. "Accuracy of point-of-care ultrasonography compared to abdominal X-ray in the diagnosis of small bowel obstruction in emergency patients." Saudi Journal of Emergency Medicine 3 (2022), 181-186. doi:
10.24911/SJEMed/72-1649057029
Alsufyani, Dina Saad, Sawsan Bagabas, Areej Alhamdi, Nawaf Basulaib, Maha Aleid, and Ali Hasan Alkhulaif. "Accuracy of point-of-care ultrasonography compared to abdominal X-ray in the diagnosis of small bowel obstruction in emergency patients." Saudi Journal of Emergency Medicine 3.3 (2022), 181-186. Print. doi:
10.24911/SJEMed/72-1649057029
Alsufyani, D. S., Bagabas, . S., Alhamdi, . A., Basulaib, . N., Aleid, . M. & Alkhulaif, . A. H. (2022) Accuracy of point-of-care ultrasonography compared to abdominal X-ray in the diagnosis of small bowel obstruction in emergency patients. Saudi Journal of Emergency Medicine, 3 (3), 181-186. doi:
10.24911/SJEMed/72-1649057029