Medical Journal of The Islamic Republic of Iran (MJIRI)
Iran University of Medical Sciences
Fri, Aug 1, 2025
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Volume 39, Issue 1 (1-2025)
Med J Islam Repub Iran 2025 |
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Chardoli M, Karimi Tajan S, Javdani Esfahani K, Mosaddegh R, Vaziri S, Mohammadi F et al . Diagnostic Accuracy of Ultrasound by Emergency Physicians in Patients with Suspected Small Bowel Obstruction (SBO): A Multi-center Study. Med J Islam Repub Iran 2025; 39 (1) :801-805
URL: http://mjiri.iums.ac.ir/article-1-9635-en.html
URL: http://mjiri.iums.ac.ir/article-1-9635-en.html
Mojtaba Chardoli 
, Shaghayegh Karimi Tajan , Kourosh Javdani Esfahani , Reza Mosaddegh , Samira Vaziri , Fatemeh Mohammadi , Alireza Javan
, Shaghayegh Karimi Tajan , Kourosh Javdani Esfahani , Reza Mosaddegh , Samira Vaziri , Fatemeh Mohammadi , Alireza Javan
Emergency Medicine Management Research Center, Health Management Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran , javan.a@iums.ac.ir
Abstract: (36 Views)
Background: Timely diagnosis of small bowel obstruction (SBO) is essential to prevent complications. While computed tomography (CT) is the gold standard for diagnosing SBO due to its high sensitivity and specificity, it has notable limitations, including radiation exposure, high cost, delayed diagnosis, and limited accessibility. Recently, ultrasound has gained attention as a potential alternative in emergency departments (ED) because it is radiation-free, cost-effective, and accessible. This multi-center study seeks to assess the diagnostic accuracy of ultrasound in identifying SBO among patients presenting to the ED.
Methods: This multicenter cross-sectional study included 100 patients with suspected SBO, examined by a trained ED physician using ultrasound and confirmed by CT. Ultrasound findings evaluated were excessive gas, bowel wall thickening, interloop free fluid, lumen diameter ≥2.5 cm, and decreased peristalsis. Sensitivity, specificity, and likelihood ratios were calculated for each finding.
Results: We found that the most efficient parameters were lumen size greater than 2.5 cm (efficacy: 73%, 95%CI: 63% - 81%), and a decrease in peristalsis (efficacy: 73%, 95%CI: 63% - 81%), The most specific parameters were excessive gas (specificity: 89%, 95%CI: 75% - 97%) and thickening of the bowel wall (specificity: 82%, 95%CI: 66% - 92%). The most sensitive parameters were interloop free fluid (sensitivity: 77%, 95%CI: 65% - 87%) and lumen diameter ≥ 2.5 cm (sensitivity: 77%, 95%CI: 65% - 87%) among other diagnostic findings.
Conclusion: Ultrasound may be a useful diagnostic tool for SBO in the ED, offering a potentially efficient and accessible option for diagnosis.
Methods: This multicenter cross-sectional study included 100 patients with suspected SBO, examined by a trained ED physician using ultrasound and confirmed by CT. Ultrasound findings evaluated were excessive gas, bowel wall thickening, interloop free fluid, lumen diameter ≥2.5 cm, and decreased peristalsis. Sensitivity, specificity, and likelihood ratios were calculated for each finding.
Results: We found that the most efficient parameters were lumen size greater than 2.5 cm (efficacy: 73%, 95%CI: 63% - 81%), and a decrease in peristalsis (efficacy: 73%, 95%CI: 63% - 81%), The most specific parameters were excessive gas (specificity: 89%, 95%CI: 75% - 97%) and thickening of the bowel wall (specificity: 82%, 95%CI: 66% - 92%). The most sensitive parameters were interloop free fluid (sensitivity: 77%, 95%CI: 65% - 87%) and lumen diameter ≥ 2.5 cm (sensitivity: 77%, 95%CI: 65% - 87%) among other diagnostic findings.
Conclusion: Ultrasound may be a useful diagnostic tool for SBO in the ED, offering a potentially efficient and accessible option for diagnosis.
Type of Study: Original Research |
Subject:
Emergency Medicine
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