An elderly M presents with abdominal pain, nausea and vomiting. He’s had weeks of symptoms, and subsequently hasn’t been eating for a couple of days and came in to get checked out.
Abdominal POCUS shows the classic ‘keyboard sign’ of a dilated, fluid filled jejunum. Dilated loops of bowel with a diameter > 2.5 cm and ‘too - and - fro’ peristalsis are useful in the diagnosis of an SBO (92.4% sensitive and 96.6% specific- Gottlieb et al 2018 Meta Analysis).
Pearls: Mean time to the diagnosis of SBO using POCUS was 11 mins (Boniface et al 2020).