Small Bowel Obstruction 67 y/o M with PMH colon cancer s/p resection and colostomy, multiple SBO managed conservatively p/w no colostomy output for 3 days and increasing abdominal distention. POCUS shows fluid-filled, noncompressible small bowel loops dilated >2.5 cm, the most sensitive finding for POCUS diagnosis of SBO. You also see characteristic to-and-fro motion of the bowel contents. You do not see signs of severe obstruction such as extraluminal free fluid, no peristalsis, or bowel wall thickening >3 mm. Recent studies report a very high positive likelihood ratio for POCUS: 9.55 for clinical US, compared to 1.6 for radiographs, 3.6 for CT, and 6.8 for MRI. Now just convince your surgeons... Dr. Angela Cai, Dr. Kelly Maurelus - Kings County/SUNY Downstate Emergency Medicine #Clinical #Radiology #POCUS #AbdominalUS #SBO #Obstruction #DilatedLoops
