Point-of-care Ultrasound to Screen for Gastrointestinal Dysfunction: Image Acquisition and Interpretation

Abstract

A major cause of morbidity and healthcare resource utilization is gastrointestinal (GI) dysfunction. Although GI symptoms are frequently evaluated with computed tomography (CT), this modality subjects patients to ionizing radiation, high costs, and high resource utilization (including sometimes inter-facility transfers from non-hospital settings). Thus, alternative methods of screening for GI dysfunction that do not subject patients to radiation and transport risk are highly desirable. One such emerging option that may help with bedside decision-making is GI point-of-care ultrasound (POCUS). However, utilization of GI POCUS is limited by a lack of training of providers and standardization in image acquisition and interpretation. To address this unmet need, we propose an evidence-based image acquisition protocol using point-of-care ultrasound to screen for two important types of GI dysfunction: ileus or obstruction. This protocol includes guidance on probe selection, patient positioning, and image acquisition sequence. Further, we review image interpretation and the limitations of this protocol.