Dilated loop of bowel with ‘too and fro’ peristalisis hinting at a downstream obstruction consistent with SBO.
A 60s year old male presented with diffuse abdominal pain and distention for a few hours. Significant history of appendectomy a week prior.
POCUS Bowel shows dilated loops of bowel > 2.5 cm with ‘too and fro’ peristalsis and the diagnosis of SBO is made in minutes.
How to do this: The next CT confirmed SBO you have, work backwards by placing the curvilinear transducer in the mid axillary line in the left lower quadrant. Work backwards like this a few times to gain the skills. Then when your pre test probability is high for the disease, POCUS first and see if you can rule in disease.
Diameter of bowl much greater than 2.5 cm (here it’s 4.5cm) consistent with small bowel obstruction.