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. 2021 Feb;5(1):127-128.
doi: 10.5811/cpcem.2020.11.50029.

Abdominal Pain in the Elderly Patient: Point-of-care Ultrasound Diagnosis of Small Bowel Obstruction

Ahmad Hussein  1 , Alexander Arena  1 , Connie Yu  1 , Angela Cirilli  1 , Ellen Kurkowski  1
Affiliations

Abdominal Pain in the Elderly Patient: Point-of-care Ultrasound Diagnosis of Small Bowel Obstruction

Ahmad Hussein et al. Clin Pract Cases Emerg Med. 2021 Feb.

Abstract

Case presentation: A 67-year-old female presented to the emergency department (ED) complaining of generalized abdominal pain, nausea, and vomiting. Point-of-care ultrasound (POCUS) demonstrated dilated bowel loops measuring up to 4.1 centimeters and localized free fluid, consistent with a small bowel obstruction (SBO). A nasogastric tube was placed without complications. The patient was admitted to the hospital and conservatively managed with an uncomplicated course.

Discussion: In elderly patients with abdominal pain, POCUS is an excellent initial imaging modality to assist emergency physicians in rapid and accurate diagnosis of a variety of pathologies to expedite management. Point-of-care ultrasound can be used to rule out and evaluate for conditions encountered in emergency medicine, including acute cholecystitis, renal colic, abdominal aortic aneurysm, and intraperitoneal free fluid. As demonstrated in our case presentation, POCUS had an integral role in the early diagnosis and management of a SBO.

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Conflict of interest statement

Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Figures

Image 1
Image 1
Point-of-care ultrasound demonstrating long-axis view of dilated, fluid-filled loops of bowel (*) measuring 4.1 centimeters from outer bowel wall to outer wall, consistent with small bowel obstruction.
Image 2
Image 2
Point-of-care ultrasound demonstrating short-axis view of dilated loops of bowel (*) with localized surrounding free fluid (white arrow) consistent with small bowel obstruction.
See this image and copyright information in PMC

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