Ultrasonographic bisection approximation method for gastrointestinal obstruction in ER.
OBJECTIVE
The aim of this study was to evaluate the accuracies of using ultrasonography in determining the levels and causes of gastrointestinal obstruction in the emergency department.


METHODS
229 patients who visited the emergency department with the clinical impression of gastrointestinal obstruction were studied. The gastrointestinal tract was systematically scanned from the anatomically fixed portions to movable portions in the peritoneum by "bisection approximation method". The obstructive levels and possible etiologies were investigated. The finding was correlated with final surgical or further radiological diagnosis.


RESULTS
The sensitivity, specificity and accuracy of ultrasonography in determining the obstruction of gastrointestinal tract were 97%, 87% and 93%. In 150 patients with diagnosis of gastrointestinal obstruction by ultrasonography, the accuracies of predicting obstructive levels in the gastric outlet and duodenum, the jejunum and ileum, and the colon were 100%, 74%, and 98% respectively. 67%, 36%, and 78% of obstructive etiologies could be correctly judged in these segments respectively.


CONCLUSIONS
Ultrasonography is a useful tool in the localization of obstructive levels and the determination of etiologies of gastrointestinal obstruction in the emergency room. It can guide physicians to choose further appropriate confirmation studies.
Lin
Cheng-Kuan
CK
Department of Internal Medicine, Far Eastern Memorial Hospital, Taiwan.
Chiu
Han-Mo
HM
Lien
Wan-Ching
WC
Liu
Yuen-Ping
YP
Chang
Chi-Yang
CY
Wang
Hsiu-Po
HP
D004636:Emergency Service, Hospital; D017219:Gastric Outlet Obstruction / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D007422:Intestines / Q000000981:diagnostic imaging / Q000601:surgery; D012680:Sensitivity and Specificity; D014463:Ultrasonography