Abdominal A-lines as an ultrasonic sign for the evaluation of gastrointestinal flatulence

Abstract

Abstract Introduction: A lot of critical illness can cause flatulence, which can give rise to gastrointestinal peristalsis disorder, gut barrier function damage, intestinal mucosal ischemia, and other conditions. Currently, in clinical practice, the suitable detection methods for gastrointestinal flatulence are lacking. The A-lines are the key characteristic defining the normal lung tissue ultrasound. The gastrointestinal tract is also the gas-bearing organ under certain conditions. When the patient has flatulence, will there be abdominal A-lines similar to lung ultrasound? In addition, whether the abdominal A-lines can be used to assess the severity of flatulence also needs proper investigation. Patient concerns: Two male patients with digestive tract tumors were transferred to department of Critical Care Medicine due to acute respiratory failure and hyperkalemia. Diagnosis: Gastrointestinal paralysis and flatulence after cavity viscera perforation. Interventions: The 2 patients with severe flatulence presented with abdominal A-lines during the ultrasound examination. Outcomes: Both the patients died when their families gave up further treatment. Conclusion: The abdominal A-lines reflect the ultrasound sign related to flatulence. Their range and location has been found to be consistent with the degree and position of gastrointestinal flatulence. In addition, in the future, it can be expected to be used to semi-quantitatively evaluate the degree and etiology of flatulence in combination with the other abdominal ultrasonographic signs.