Point-of-care ultrasound of the gastrointestinal tract

Abstract

The widespread use of portable ultrasound scanners has promoted the concept of point of care ultrasound (POCUS), namely “ultrasound performed bedside and interpreted directly by the clinician.” The purpose of this short review is to outline how POCUS can be used in patients with diseases of the gastrointestinal (GI) tract. POCUS is not a replacement for comprehensive ultrasound, but rather allows physicians immediate access to clinical imaging for rapid diagnosis and efficient work-up and treatment of the patients. There are many indications for doing POCUS of the GI tract, including abdominal pain, diarrhea, palpable masses, and to detect fluid or free air in the abdominal cavity. To improve the visibility of deeper parts of the abdomen, the graded compression technique with the scan head is useful. During POCUS, the operator should look for signs of severe pathology including target lesions, the pseudo-kidney sign, the onion sign, dilated bowel loops, gastric retention, free fluid, and free air, depending on the actual clinical problem. We conclude that POCUS of the GI tract is very useful to provide a rapid diagnosis in many clinical scenarios.