Echoes from Within: Mapping Gastrointestinal Obstruction with Ultrasound

TL;DR

This paper explores how ultrasound can help quickly assess and monitor gastrointestinal blockages, offering a safer and faster alternative to CT scans.

Contribution

The paper introduces practical ultrasound techniques for triaging and monitoring gastrointestinal obstruction severity and progression.

Findings

POCUS can provide insights into GI size and function without radiation or transport.

Serial POCUS exams can track obstruction progression or resolution over time.

Sonographic findings can help distinguish between types of GI obstruction.

Abstract

Patients presenting with abdominal pain and/or distension require rapid diagnostics to narrow the differential diagnosis from a long list of obstructive gastrointestinal (GI) pathologies that may appear clinically similar but warrant distinct management. While the workup of abdominal distension currently centers around computed tomography (CT), this modality is costly, requires radiation exposure, and necessitates patient transport, potentially delaying care. In contrast, point-of-care ultrasound (POCUS) avoids ionizing radiation and the need for patient transport while providing some insight into the gastrointestinal size and function. While POCUS cannot currently replace CT in the definitive diagnosis of GI obstructive pathologies, it remains a promising tool to help with the initial triage and monitoring responses to therapy for several causes of functional and/or mechanical GI obstruction, such as gastric dilation, ileus, and small bowel obstruction. Because the obstruction severity and features can evolve over time, POCUS enables serial examinations to monitor the progression or resolution. This manuscript reviews characteristic sonographic findings that help distinguish obstructive GI conditions and highlights practical techniques for integrating gastric and intestinal POCUS to improve diagnostic accuracy and expedite treatment.

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