Diagnostic Performance of Point of Care Ultrasound to Identify Intestinal Obstruction

Study Overview
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Brief Summary
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As reported in previous studies, Point-of-Care Ultrasound (POCUS) has good performance for the diagnosis of bowel obstruction even when compared with CT. This inexpensive, radiation-free tool is available in a majority of ED. It is performed at the patient's bedside with immediate results. The learning curve allows Emergency Physicians (EP) to perform this exam after a relative brief training period. The investigators aim to investigate the ability of POCUS performed before CT to exclude the diagnosis of bowel obstruction in patients admitted for abdominal pain.

Detailed Description
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Bowel obstruction (BO) is frequently suspected in the Emergency Department (ED). Computed Tomography (CT) is commonly used to diagnose this disease. However, CT is not always available in real-time, requires technician times, is associated with increased cost and exposes patients to radiations. The researchers will investigate the diagnosis performances of POCUS for the diagnosis of BO with comparison with CT which will be considered as the gold standard. The wain objective will be the ability to exclude the diagnosis of BO, the main criteria being the negative predictive value. The secondary objectives will be the diagnosis performances (sensitivity, specificity, positive predictive value), duration and difficulty of POCUS

Official Title
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Diagnostic Performance of Point of Care Ultrasound to Identify Intestinal Obstruction

Conditions
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Bowel Obstruction

Intervention / Treatment
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* Other: Point-of-Care Ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria : Adult patients Abdominal pain Suspected bowel obstruction Exclusion Criteria : - Documented end-of-life precluding CT realization

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Point-of-Care Ultrasound|Patients admitted to the ED with abdominal pain and suspicion of bowel obstruction : realization of a Point-of-Care Ultrasound after clinical exam by the Emergency Physician in charge as a standard of care. Beside usual findings, the investigators will search for signs of bowel obstruction: dilated and incompressible small bowel loop, back-and-forth peristalsis sign. Determination of probability of small bowel obstruction. Realization of a computed tomography in search of small bowel obstruction.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Negative predictive value of POCUS | Negative predictive value of POCUS for the diagnosis of bowel obstruction compared with computed tomography result | Through ED stay, up to 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Positive predictive value of POCUS for the diagnosis of bowel obstruction | Positive predictive value | Through ED stay, up to 24 hours | 
| Sensitivity of POCUS for the diagnosis of bowel obstruction | sensitivity of POCUS, for the diagnosis of bowel obstruction compared with computed tomography result | Through ED stay, up to 24 hours | 
| Specificity of POCUS for the diagnosis of bowel obstruction | specificity of POCUS, for the diagnosis of bowel obstruction compared with computed tomography result | Through ED stay, up to 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Bowel obstruction, Computed tomography, Ultrasound