Abdominal Pain in the Elderly Patient: Point-of-care Ultrasound Diagnosis of Small Bowel Obstruction.

Ahmad Hussein,Alexander Arena,Ellen Kurkowski,Angela Cirilli,Connie Yu

doi:10.5811/cpcem.2020.11.50029

Abstract

Case PresentationA 67-year-old female presented to the emergency department (ED) complaining of generalized abdominal pain, nausea, and vomiting. Point-of-care ultrasound (POCUS) demonstrated dilated bowel loops measuring up to 4.1 centimeters and localized free fluid, consistent with a small bowel obstruction (SBO). A nasogastric tube was placed without complications. The patient was admitted to the hospital and conservatively managed with an uncomplicated course.DiscussionIn elderly patients with abdominal pain, POCUS is an excellent initial imaging modality to assist emergency physicians in rapid and accurate diagnosis of a variety of pathologies to expedite management. Point-of-care ultrasound can be used to rule out and evaluate for conditions encountered in emergency medicine, including acute cholecystitis, renal colic, abdominal aortic aneurysm, and intraperitoneal free fluid. As demonstrated in our case presentation, POCUS had an integral role in the early diagnosis and management of a SBO.

Highlights

Point-of-care ultrasound can be used to rule out and evaluate for conditions encountered in emergency medicine, including acute cholecystitis, renal colic, abdominal aortic aneurysm, and intraperitoneal free fluid
As demonstrated in our case presentation, Point-of-care ultrasound (POCUS) had an integral role in the early diagnosis and management of a Small bowel obstruction (SBO). [Clin Pract Cases Emerg Med. 2021;5(1):127–128.]
CASE PRESENTATION A 67-year-old female with a history of hypertension, diabetes, and exploratory laparotomy presented with abdominal pain for one day associated with nausea, nonbloody-nonbilious emesis, and normal bowel movements

Summary

Images in Emergency Medicine

Abdominal Pain in the Elderly Patient: Point-of-care Ultrasound Diagnosis of Small Bowel Obstruction. St. John’s Riverside Hospital, Department of Emergency Medicine, Yonkers, New York. Case Presentation: A 67-year-old female presented to the emergency department (ED) complaining of generalized abdominal pain, nausea, and vomiting. Point-of-care ultrasound (POCUS) demonstrated dilated bowel loops measuring up to 4.1 centimeters and localized free fluid, consistent with a small bowel obstruction (SBO). The patient was admitted to the hospital and conservatively managed with an uncomplicated course

Discussion

DISCUSSION

Findings

POCUS Diagnosis of Small Bowel Obstruction