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Powerpoint –> IOTW 1-1-18
Case
- 36 yo F presents to ED for abdominal pain. Abdominal pain is located in the RUQ and LLQ. Associated with one episode of diarrhea in the morning and emesis.
- ED team requested a RUQ sono to assess for biliary pathology
- During the exam, the patient asked “ Can you look here where it’s REALLY hurting?” and pointed to LLQ
Small Bowel Obstruction On Ultrasound?
Criteria of SBO
- dilated bowel loop (diameter > 2.5 cm)
- bowel wall thickening > 3mm
- fluid-filled distended bowel with extra luminal free fluid between bowel loops
- Back and forth peristalsis
- May see transition point
What happened to the patient:
- Patient was found to have an SBO on CT scan. She went to the OR for an emergent ex-lap and was found to have frank pus in her abdomen without any signs of perforation.
Emergency Medicine Residency Program 