Small Bowel Obstruction and the Role of Bedside Ultrasonography Performed by a Pediatric Emergency Physician: A Case Report.

Abstract

Small bowel obstruction (SBO) is a relatively uncommon urgent condition that may require surgical treatment. However, initial symptoms of patients who present with SBO are often nonspecific and may be confused with those of more common pediatric illnesses. Although the number of true SBO cases requiring emergency attention is few, distinguishing SBO from the more common less urgent pediatric abdominal conditions is vital for the most effective patient care. Therefore, immediate and accurate identification of this condition is essential in order to avoid delays in diagnosis that may increase morbidity and mortality. We report a case involving a 7-year-old girl who initially presented with abdominal pain and vomiting. A bedside ultrasonography performed by the pediatric emergency physician allowed for the initiation of appropriate, rapid decision making including extensive examination and management. Although bedside ultrasonography has been used in the past to diagnose SBO in adult patients, this is the first report on diagnosing a pediatric patient with SBO utilizing bedside ultrasonography considering criteria that are different from those for children in the past case series. Here, we also review SBO and its diagnostic modalities and the role of the pediatric emergency physician in performing ultrasonography.