Bowel Obstruction
Conditions
Keywords
Bowel obstruction, Computed tomography, Ultrasound
Brief summary
As reported in previous studies, Point-of-Care Ultrasound (POCUS) has good performance for the diagnosis of bowel obstruction even when compared with CT. This inexpensive, radiation-free tool is available in a majority of ED. It is performed at the patient's bedside with immediate results. The learning curve allows Emergency Physicians (EP) to perform this exam after a relative brief training period. The investigators aim to investigate the ability of POCUS performed before CT to exclude the diagnosis of bowel obstruction in patients admitted for abdominal pain.
Detailed description
Bowel obstruction (BO) is frequently suspected in the Emergency Department (ED). Computed Tomography (CT) is commonly used to diagnose this disease. However, CT is not always available in real-time, requires technician times, is associated with increased cost and exposes patients to radiations. The researchers will investigate the diagnosis performances of POCUS for the diagnosis of BO with comparison with CT which will be considered as the gold standard. The wain objective will be the ability to exclude the diagnosis of BO, the main criteria being the negative predictive value. The secondary objectives will be the diagnosis performances (sensitivity, specificity, positive predictive value), duration and difficulty of POCUS
Interventions
OTHERPoint-of-Care Ultrasound
Patients admitted to the ED with abdominal pain and suspicion of bowel obstruction : realization of a Point-of-Care Ultrasound after clinical exam by the Emergency Physician in charge as a standard of care. Beside usual findings, the investigators will search for signs of bowel obstruction: dilated and incompressible small bowel loop, back-and-forth peristalsis sign. Determination of probability of small bowel obstruction. Realization of a computed tomography in search of small bowel obstruction.
Sponsors
Nantes University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
: * Adult patients * Abdominal pain * Suspected bowel obstruction
Exclusion criteria
: \- Documented end-of-life precluding CT realization
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Negative predictive value of POCUS | Through ED stay, up to 24 hours | Negative predictive value of POCUS for the diagnosis of bowel obstruction compared with computed tomography result |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Positive predictive value of POCUS for the diagnosis of bowel obstruction | Through ED stay, up to 24 hours | Positive predictive value |
| Sensitivity of POCUS for the diagnosis of bowel obstruction | Through ED stay, up to 24 hours | sensitivity of POCUS, for the diagnosis of bowel obstruction compared with computed tomography result |
| Specificity of POCUS for the diagnosis of bowel obstruction | Through ED stay, up to 24 hours | specificity of POCUS, for the diagnosis of bowel obstruction compared with computed tomography result |
Countries
France
Outcome results
None listed