Clip 1: Dilated loop of bowel that with no peristalsis.
A diameter > 2.5 cm is consistent with an obstruction.
A 30-something patient with a history of previous abdominal surgeries complains of epigastric abdominal pain and vomiting. POCUS biliary is normal. She’s had a few episodes of emesis and isn’t getting better with treatment. A CT is ultimately performed and she has a small bowel obstruction (SBO).
Abdominal POCUS in clip 1 of CT confirmed SBO shows a dilated loop of bowel with no peristalsis. The still image shows a diameter of 3.6 cm, well above the cutoff of 2.5 cm which is diagnostic for SBO.
POCUS Pearl: Going back to your patient who has (CT, Xray, MRI etc.) confirmed pathology and learning what a true positive looks like on POCUS is one of the best ways to learn. Why learn? Mean time to diagnosis of SBO by POCUS was 11 minutes, versus 3 hours and 42 mins by CT [https://doi.org/10.1016/j.annemergmed.2019.05.031]. Not arguing against the CT, arguing for the addition of POCUS.