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. 2023 Nov 18;15(11):e49031.
doi: 10.7759/cureus.49031. eCollection 2023 Nov.

Rapid Evaluation of Gastric Content With Ultrasound: An Educational Tool

Huynh Nguyen  1 , Matthew R Paluska  2 , Ricardo Falcon  3 , Timothy R Petersen  4   3   5 , Codruta Soneru  3
Affiliations

Rapid Evaluation of Gastric Content With Ultrasound: An Educational Tool

Huynh Nguyen et al. Cureus. .

Abstract

Pulmonary aspiration is a severe complication in patients receiving anesthesia for surgical procedures. The risk and severity of aspiration are significantly higher in the presence of substantial gastric contents. Bedside ultrasound imaging of the gastric antrum is emerging as a rapid and valuable method to evaluate gastric contents before surgery. Rapid gastric ultrasound using a three-category grading system promotes timely decision-making to help in emergent or urgent surgeries by identifying patients with potentially high gastric volumes or solid food contents. In emergent cases with limited time, a single ultrasound view of the gastric antrum is still likely to yield helpful information. In this report, we argue that bedside ultrasound offers a more reliable assessment of gastric contents than assumptions based on time-based fasting guidelines.

Keywords: anesthesiology; aspiration risk; gastric content; gastric ultrasound; preoperative assessment; ultrasound.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. While the patient is in the right lateral decubitus position, the ultrasound probe is placed in the parasagittal plane just right of the midline for a parasagittal view of the gastric antrum
Created with BioRender.com
Figure 2
Figure 2. (A) Approximate ultrasound probe location and orientation for a parasagittal view of the gastric antrum; (B) Approximate ultrasound probe location and orientation for an axial view of the gastric antrum; parasagittal (C, E, G, I) and axial (D, F, H, J) views of the gastric antrum in: empty stomach state (C, D); 1 hour after ingestion of clear liquids (E, F); 1 minute after drinking approximately 500 mL (16 oz) of clear liquids showing characteristic expanded lumen with hypoechoic contents (G, H); and immediately following a meal with characteristic "ground-glass" appearance (I, J)
Created with BioRender.com A: antrum; Ao: aorta; D: duodenum; hr: hour; IVC: inferior vena cava; L: liver; min: minute; NPO: nil per os; oz: ounce; P: pancreas; Py: pylorus; SMA: superior mesenteric artery
See this image and copyright information in PMC

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