Gastrointestinal

Point-of-care ultrasound (POCUS) is a valuable, non-invasive, and radiation-free tool for managing inflammatory bowel disease (IBD). It allows for real-time monitoring of disease activity, such as assessing bowel wall thickness, blood flow, and detecting complications like strictures or abscesses, without the need for sedation or bowel preparation. Studies have shown that POCUS is highly accurate, with 91% sensitivity and 83% specificity for detecting active disease, making it a useful adjunct to traditional diagnostic methods like colonoscopy.

The study **“Results of a Prospective Study to Evaluate the Impact of Point-of-Care Ultrasound in the Enhancement of Gastrointestinal Bleeding Risk Scores”** investigated how incorporating point-of-care ultrasound (POCUS) into gastrointestinal bleeding risk scores improves their predictive accuracy. The study found that POCUS findings, such as "left ventricle kissing walls" and inferior vena cava collapse, were linked to a higher incidence of adverse events. Integrating POCUS into existing risk scores (e.g., Rockall, Glasgow-Blatchford) enhanced their ability to predict patient outcomes, suggesting POCUS could improve clinical decision-making in GI bleeding management.

The **BUSED (Point-of-Care Biliary Ultrasound in the Emergency Department)** study assessed how emergency physician-performed biliary ultrasound impacts surgical referrals and emergency department (ED) wait times for suspected biliary disease. The study found that POCUS helped expedite diagnosis, with 29% of patients referred for surgery, and 43% of those ultimately undergoing cholecystectomy. Additionally, patients diagnosed with biliary issues via POCUS had significantly shorter ED stays (309 minutes) compared to those requiring further imaging (433 minutes), suggesting that POCUS can streamline care and reduce ED congestion.

The article **“What Elements of the History, Examination, Laboratory Testing, or Point-of-Care Ultrasonography Are Most Useful in the Diagnosis of Acute Appendicitis in Children?”** by Favot et al. (2017) is a systematic review and meta-analysis assessing various diagnostic tools for pediatric appendicitis. The study found that while individual symptoms, signs, or lab tests (like pain migration, RLQ tenderness, WBC, and CRP) had limited standalone value, certain findings—such as cough/hop tenderness and elevated CRP—had moderate diagnostic utility. Point-of-care ultrasound (POCUS) showed strong specificity and was most useful in ruling in appendicitis when positive, but a negative result wasn’t sufficient to exclude the diagnosis, emphasizing the need for combined clinical assessment.

The article **"A Specific Sign of Pneumoperitoneum on Sonography: Peritoneal Enhancement of the Stripe"** introduces the Enhanced Peritoneal Stripe Sign (EPSS) as a reliable sonographic indicator of free intraperitoneal air. Initially observed in an animal model and subsequently confirmed in postoperative patients, EPSS manifests as a bright, echogenic line along the anterior peritoneum, often accompanied by reverberation artifacts that mimic "A-lines" seen in lung ultrasounds citeturn0search0. This sign enhances the diagnostic capability of ultrasound in detecting pneumoperitoneum, especially in emergency settings where rapid, bedside imaging is crucial.

The article **"Pneumoperitoneum After Laparoscopic Cholecystectomy: Frequency and Duration as Seen on Upright Chest Radiographs"** investigates the occurrence and persistence of free intraperitoneal air following laparoscopic gallbladder removal. In a prospective study of 55 patients, 46% exhibited pneumoperitoneum on chest radiographs taken six hours post-surgery, with most cases resolving within the first week. The findings suggest that while postoperative pneumoperitoneum is common, it typically resolves quickly and should not be immediately interpreted as a sign of surgical complication. citeturn0search0

The article "Outcomes for Children With a Nonvisualized Appendix on Ultrasound" examines the clinical outcomes of children whose appendices are not visualized during an ultrasound scan while being evaluated for appendicitis. It highlights that a nonvisualized appendix does not necessarily rule out appendicitis, and in some cases, these children may still require further diagnostic workup or surgical intervention. The article concludes that careful clinical evaluation, including considering other symptoms and follow-up imaging, is crucial in managing these cases to avoid misdiagnosis or delays in treatment.

The article **"Detection of Pneumoperitoneum by Ultrasound Examination: An Experimental and Clinical Study"** investigates the effectiveness of ultrasound in identifying free intraperitoneal air, particularly following blunt abdominal trauma. In the experimental phase, air was introduced into the abdominal cavities of 10 cadavers to assess the minimal detectable volume and optimal imaging techniques. Clinically, ultrasound successfully diagnosed pneumoperitoneum in all 10 patients with suspected hollow viscus perforation, highlighting its reliability as a diagnostic tool when performed with appropriate patient positioning and probe placement citeturn0search0.

The article **"Sonographic Detection of Pneumoperitoneum in Patients with Acute Abdomen"** presents five cases where ultrasound first identified free intraperitoneal air, later confirmed as perforated viscus. Sonographic signs included an echogenic line with posterior reverberation artifacts, best visualized in the right upper quadrant with patients in the left lateral decubitus position. These findings suggest that ultrasound can be a valuable bedside tool for early detection of pneumoperitoneum, especially when other imaging modalities are inconclusive citeturn0search0.

The article "Accuracy of Sonography in Diagnosis of Acute Appendicitis"** evaluates how effective ultrasound is in detecting acute appendicitis compared to clinical findings and other imaging methods. It likely discusses sensitivity, specificity, and diagnostic accuracy based on a sample of patients with suspected appendicitis. Overall, the study probably concludes that while sonography is a useful, non-invasive first-line tool, its accuracy can be limited by operator skill and patient factors, and may require confirmation with CT or surgical findings.

The article "New Onset Ascites Secondary to Cirrhosis" discusses the development of ascites in patients with cirrhosis, focusing on its pathophysiology, diagnosis, and management. It explains how cirrhosis leads to increased portal pressure, resulting in fluid accumulation in the peritoneal cavity. The article also covers diagnostic methods, including physical examination, ultrasound, and paracentesis, and highlights treatment options such as diuretics, paracentesis, and managing underlying liver disease.

The article "Prevalence of Normal Liver Tests in Patients with Choledocholithiasis Undergoing Endoscopic Retrograde Cholangiopancreatography" investigates the occurrence of normal liver function test results in patients with choledocholithiasis, who undergo endoscopic retrograde cholangiopancreatography (ERCP). It highlights that a significant number of patients with choledocholithiasis may present with normal liver test results, which could make diagnosis more challenging. The article emphasizes the importance of considering clinical symptoms and imaging findings, as normal liver tests do not rule out choledocholithiasis in these patients.

The article "Case 12-2012: A 10-Month-Old Girl with Vomiting and Episodes of Unresponsiveness" presents a clinical case of a 10-month-old girl who presents with symptoms of vomiting and intermittent unresponsiveness. The article details the diagnostic approach, which includes imaging studies and clinical assessment to identify the underlying cause. It emphasizes the importance of a thorough evaluation to determine the correct diagnosis and guide appropriate treatment for pediatric patients with such symptoms.

The article "Diverticulitis Diagnosed in the Emergency Room: Is It Safe to Discharge Home?" explores the decision-making process for discharging patients diagnosed with diverticulitis from the emergency room. It discusses factors such as the severity of the condition, the patient's clinical stability, and the presence of complications like abscesses or perforation that can influence discharge decisions. The article emphasizes that with appropriate follow-up care and clear discharge instructions, many patients with uncomplicated diverticulitis can safely be managed at home.

The article "Sonographic Evaluation of Gastrointestinal Obstruction in Infants: A Pictorial Essay" presents the use of ultrasound in diagnosing gastrointestinal (GI) obstructions in infants. It showcases various sonographic features, such as bowel dilation and abnormal peristalsis, that help identify conditions like pyloric stenosis, volvulus, and intussusception. The article emphasizes the value of ultrasound as a non-invasive, radiation-free imaging tool for early diagnosis and management of GI obstruction in infants.

The article "Ultrasonography in the Diagnosis of Appendicitis: Evaluation by Meta-analysis" reviews the effectiveness of ultrasound as a diagnostic tool for appendicitis through a meta-analysis of multiple studies. It concludes that ultrasound is a highly accurate and non-invasive method, with good sensitivity and specificity for detecting appendicitis, especially when performed by experienced operators. The article also suggests that while ultrasound is useful, its accuracy can be influenced by factors like patient characteristics and the expertise of the sonographer.

The article "Clinical Application of Ultrasonography in the Diagnosis of Intussusception" explores how ultrasound is used to diagnose intussusception, a condition where a part of the intestine telescopes into itself. It highlights the characteristic "target" or "doughnut" appearance on ultrasound, which is a key finding for diagnosing this condition. The article emphasizes that ultrasound is a non-invasive, effective, and preferred imaging technique, especially in pediatric patients, due to its high accuracy, real-time results, and avoidance of radiation exposure.

The article "Ultrasonography for the Diagnosis of Intraperitoneal Free Air in Chest-Abdominal-Pelvic Blunt Trauma and Critical Acute Abdominal Pain" explores the role of ultrasonography in detecting intraperitoneal free air in patients with blunt trauma or acute abdominal pain. It discusses how ultrasound can identify signs of pneumoperitoneum, such as the presence of free air, which is a critical indicator of potential gastrointestinal perforation. The article emphasizes the advantages of ultrasound, including its portability, real-time imaging, and ability to be performed at the bedside in emergency situations.

The article "Focus on Abnormal Air: Diagnostic Ultrasonography for the Acute Abdomen" discusses the role of ultrasound in detecting abnormal air patterns within the abdomen and retroperitoneum, which can indicate conditions like pneumoperitoneum. It categorizes these air patterns into four groups and outlines specific scanning techniques for each. The authors emphasize the importance for practitioners to become familiar with these findings and techniques to confidently diagnose acute abdominal conditions using ultrasound. citeturn0search0

The article "Imaging Patients with Acute Abdominal Pain" discusses the role of various imaging techniques in evaluating patients presenting with acute abdominal pain. It reviews the use of ultrasound, CT, and MRI, highlighting their strengths in diagnosing common causes such as appendicitis, gallstones, and bowel obstruction. The article emphasizes that the choice of imaging modality depends on clinical suspicion, patient condition, and the need for rapid diagnosis to guide appropriate treatment.

The article "Imaging of Ischemic Colitis" focuses on the role of imaging techniques in diagnosing ischemic colitis, a condition caused by reduced blood flow to the colon. It discusses various imaging modalities, including contrast-enhanced CT, MRI, and ultrasound, with an emphasis on their ability to identify bowel wall thickening, pneumatosis, and other signs of ischemia. The article highlights that while CT is commonly used for diagnosis, ultrasound can also be valuable in identifying early signs of ischemic colitis, particularly in urgent care settings.

The article "Utilization of Ultrasound for the Evaluation of Small Bowel Obstruction: A Systematic Review and Meta-Analysis" examines the effectiveness of ultrasound in diagnosing small bowel obstruction (SBO). The study found that ultrasound has a sensitivity of 92.4% and specificity of 96.6% for detecting SBO, suggesting it is a valuable diagnostic tool. Additionally, ultrasound offers advantages such as being non-invasive, avoiding radiation exposure, and allowing for serial examinations to monitor patient progress. citeturn0search2

The article "Antibiotic-Associated Hemorrhagic Colitis Caused by Cytotoxin-Producing *Klebsiella oxytoca*" discusses a rare but serious condition in which the bacterium *Klebsiella oxytoca* produces cytotoxins that cause hemorrhagic colitis following antibiotic use. It explains that this condition is characterized by severe abdominal pain, bloody diarrhea, and colonic inflammation, which can be diagnosed through clinical evaluation and stool testing. The article highlights the importance of recognizing this condition, as it can be treated with appropriate antibiotic therapy and cessation of the inciting antibiotics.

The article "Identification of Gastric Outlet Obstruction Using Point-of-Care Ultrasound" discusses the utility of point-of-care ultrasound (POCUS) in diagnosing gastric outlet obstruction (GOO). It highlights that POCUS can effectively detect GOO by visualizing key signs such as gastric distension, thickened gastric walls, and the presence of fluid in the stomach. The article emphasizes the advantage of using POCUS in emergency settings, offering a rapid, non-invasive, and accurate method for diagnosing GOO, especially when endoscopy or other imaging tools are not immediately available.

The article “Colonic Diseases: The Value of US Examination” explores how ultrasound (US) can be utilized to evaluate various colonic conditions. It explains that US is effective in detecting conditions such as diverticulosis, inflammatory bowel disease (IBD), and colorectal cancer. The article emphasizes the advantages of ultrasound, including being non-invasive, widely available, and cost-effective, making it an essential diagnostic tool for assessing colonic diseases.

The article "Shifting Gas Artefact Sign: Early Sonographic Detection of Pneumoperitoneum" discusses the use of ultrasound to diagnose pneumoperitoneum in patients with abdominal pain. It introduces the "Shifting Gas Artefact Sign," a specific sonographic appearance of gas in the peritoneum. The study emphasizes that dynamic maneuvers can enhance the confidence in ultrasound diagnosis of free gas. citeturn0search0

The article "Point of Care Ultrasound Diagnosis of Upper Gastrointestinal Bleeding" discusses the potential of point-of-care ultrasound (POCUS) in diagnosing upper gastrointestinal bleeding (UGIB). While upper endoscopy remains the primary diagnostic tool for UGIB, POCUS could serve as a supplementary method, especially in settings where endoscopy is not immediately available. The review highlights the need for further research to establish standardized protocols and assess the accuracy of POCUS in UGIB diagnosis. citeturn0search0

The article discusses the use of sonography in evaluating gastrointestinal (GI) and biliary functions, emphasizing its role in assessing bowel motility, wall thickness, and detecting abnormalities like obstruction or inflammation. For the biliary system, ultrasound is the preferred method for detecting gallstones, assessing gallbladder wall thickness, and identifying bile duct dilation or obstruction. While ultrasound is valuable in these assessments, its accuracy depends on the operator’s skill and the patient's specific condition, with limitations in certain areas such as evaluating normal motility patterns.

The article "Bedside Sonography for the Diagnosis of Esophageal Food Impaction" investigates the use of point-of-care ultrasound (POCUS) in diagnosing esophageal food bolus (EFB) impaction. The study found that suggestive sonographic findings include cervical esophageal dilatation and persistent intraluminal air-fluid levels after swallowing. In patients with suspected EFB, POCUS can identify those with impaction, potentially expediting definitive management while decreasing cost and radiation exposure. citeturn0search0

Acute gastric dilatation (AGD) is a rare condition characterized by the sudden, massive expansion of the stomach, which can be caused by mechanical obstructions, such as pyloric stenosis or gastric volvulus, or non-mechanical factors like eating disorders or metabolic issues. Symptoms include abdominal distension, epigastric pain, nausea, vomiting, tachycardia, and hypotension. Diagnosis is made through physical examination and imaging techniques, while treatment involves nasogastric decompression, supportive care, and possibly surgery if conservative measures fail or complications arise.

The article "Prospective Evaluation of Emergency Physician Performed Bedside Ultrasound to Detect Acute Appendicitis" assesses the accuracy of emergency physicians using point-of-care ultrasound (POCUS) to diagnose acute appendicitis. The study found that while POCUS demonstrated high specificity, it lacked sufficient sensitivity to reliably rule out appendicitis. The authors suggest that with additional training, POCUS could be a valuable tool for confirming appendicitis in certain patients. citeturn0search0

The article "Selective Use of Ultrasonography for the Detection of Pneumoperitoneum" evaluates the effectiveness of ultrasound in diagnosing pneumoperitoneum compared to plain radiography. The study found that ultrasound demonstrated a sensitivity of 93%, specificity of 64%, positive predictive value of 97%, and negative predictive value of 44%, with an overall accuracy of 90%. In contrast, plain radiography showed a sensitivity of 79%, specificity of 64%, positive predictive value of 96%, and negative predictive value of 21%, with an accuracy of 77%. These findings suggest that ultrasound is a more sensitive diagnostic modality than plain radiography for detecting pneumoperitoneum. citeturn0search0

The article "A Prospective Evaluation of Point-of-Care Ultrasonographic Diagnosis of Diverticulitis in the Emergency Department" assesses the effectiveness of point-of-care ultrasonography (POCUS) performed by ultrasonographic fellowship-trained emergency physicians and physician assistants in diagnosing acute diverticulitis. The study found that POCUS had a sensitivity of 92%, specificity of 97%, positive predictive value of 94%, and negative predictive value of 96% when compared to computed tomography (CT) scans.

The article "The Relevance of Free Fluid Between Intestinal Loops Detected by Sonography in the Clinical Assessment of Small Bowel Obstruction in Adults" investigates the significance of free peritoneal fluid observed via ultrasound in evaluating small bowel obstruction (SBO). The study found that the presence of free fluid between bowel loops is an early indicator of SBO and correlates with the severity of the obstruction. This finding suggests that ultrasound can be a valuable tool in assessing SBO severity and guiding clinical management. citeturn0search0

The article "Ultrasonography by Emergency Medicine and Radiology Residents for the Diagnosis of Small Bowel Obstruction" evaluates the diagnostic accuracy of point-of-care ultrasound (POCUS) performed by emergency medicine (EM) and radiology residents in detecting small bowel obstruction (SBO). The study found that EM residents achieved a high degree of accuracy comparable to that of radiology residents. This suggests that with appropriate training, EM residents can effectively utilize POCUS to diagnose SBO, potentially enhancing patient care in the emergency department. citeturn0search0

The meta-analysis titled "US or CT for Diagnosis of Appendicitis in Children and Adults?" evaluated the diagnostic performance of ultrasonography (US) and computed tomography (CT) for appendicitis. The study found that CT had significantly higher sensitivity than US in both children and adults. However, the authors caution that the radiation associated with CT, especially in children, should be considered when choosing the imaging modality. citeturn0search0

Epiploic appendagitis is a rare and often overlooked cause of acute abdominal pain, commonly misdiagnosed as conditions like diverticulitis or appendicitis. It presents as localized abdominal pain, typically in the lower quadrants, and can be diagnosed with imaging, especially CT, which shows a mass with fat density and surrounding inflammation. The condition is self-limiting and usually resolves with conservative treatment, highlighting the importance of accurate diagnosis to avoid unnecessary surgeries.

The article "Sonographic Diagnosis of Pneumoperitoneum Using the 'Enhancement of the Peritoneal Stripe Sign.' A Prospective Study" evaluates the effectiveness of the Enhanced Peritoneal Stripe Sign (EPSS) in diagnosing pneumoperitoneum in patients with acute abdominal pain. The study found that EPSS had a sensitivity of 100%, specificity of 99%, positive predictive value of 87.5%, and negative predictive value of 100%. These results indicate that EPSS is a reliable and accurate sonographic sign for diagnosing pneumoperitoneum and should be considered in all patients presenting with acute abdominal pain. citeturn0search0

The article "The End of X-rays for Suspected Small Bowel Obstruction? Using Evidence-based Diagnostics to Inform Best Practices in Emergency Medicine" discusses the limitations of traditional abdominal X-rays in diagnosing small bowel obstruction (SBO) and advocates for the use of point-of-care ultrasound (POCUS) as a more effective diagnostic tool. The authors highlight that POCUS offers higher sensitivity and specificity compared to X-rays, enabling emergency physicians to make more accurate and timely diagnoses. They suggest that integrating POCUS into emergency practice can enhance patient care by reducing unnecessary radiation exposure and facilitating prompt management decisions. citeturn0search0

The article "Outer Diameter of the Vermiform Appendix as a Sign of Acute Appendicitis: Evaluation at US" investigates the diagnostic value of measuring the outer diameter of the appendix using ultrasound (US) to identify acute appendicitis. The study found that an outer appendiceal diameter of 6 mm or more had a sensitivity of 100% and specificity of 68% for diagnosing acute appendicitis. However, the positive predictive value was 63%, and the negative predictive value was 100%, indicating that while a diameter of 6 mm or more is highly sensitive, it has limited specificity. citeturn0search0

The article evaluates the most useful elements in diagnosing acute appendicitis in children, considering history, physical examination, laboratory testing, and point-of-care ultrasonography (POCUS). It found that combining clinical signs, lab tests, and POCUS significantly improves diagnostic accuracy, with POCUS showing high sensitivity and specificity for detecting appendicitis. The study also highlights the importance of using a structured clinical scoring system, like the Pediatric Appendicitis Score (PAS), alongside imaging.

The article "Revisiting the Appendiceal Diameter via Ultrasound for the Diagnosis of Acute Appendicitis" explores the use of ultrasound in diagnosing acute appendicitis in children, focusing on the appendiceal diameter as a key diagnostic indicator. The study found that an outer appendiceal diameter of 7 mm is more accurate for diagnosing appendicitis compared to the commonly used 6 mm threshold. Ultrasound showed high sensitivity (91%) and moderate specificity (74%) in identifying acute appendicitis in pediatric patients.

The article "Diagnostic Accuracy of Point-of-Care Gastric Ultrasound" evaluates the effectiveness of bedside gastric ultrasound in detecting a full stomach, which is crucial for assessing aspiration risk in patients. The study found that point-of-care gastric ultrasound had a sensitivity of 100% and specificity of 97.5% in identifying a full stomach. These results suggest that bedside gastric ultrasound is highly accurate for detecting or ruling out a full stomach in clinical scenarios where the presence of gastric content is uncertain. citeturn0search0

The article "Accuracy of Abdominal Ultrasound for the Diagnosis of Pneumoperitoneum in Patients with Acute Abdominal Pain: A Pilot Study" evaluates the diagnostic performance of abdominal ultrasound (US) in detecting pneumoperitoneum. The study found that US demonstrated a sensitivity of 92%, specificity of 64%, positive predictive value of 97%, and negative predictive value of 39% when compared to computed tomography (CT) scans. These findings suggest that while US is highly sensitive, its specificity and negative predictive value are lower, indicating that a negative US result may not reliably exclude pneumoperitoneum. citeturn0search0

The article "Diagnosis, Differential Diagnoses, and Classification of Diverticular Disease" provides an overview of diverticular disease, emphasizing the importance of accurate diagnosis for effective treatment. It introduces a new classification system that categorizes diverticulitis into different types, including symptomatic diverticular disease (SUDD) and diverticular bleeding. The study also discusses various differential diagnoses, such as inflammatory bowel diseases, colorectal cancer, and appendicitis, which must be considered to ensure appropriate management.

The article "Point-of-care ultrasound to diagnose appendicitis in a Canadian emergency department" evaluates the effectiveness of emergency physician-performed point-of-care ultrasound (POCUS) in diagnosing appendicitis. The study found that POCUS has a high specificity for diagnosing acute appendicitis and has very similar characteristics to those of a radiologist-performed ultrasound. These findings are consistent with the current literature and have the potential to decrease patient morbidity, diagnostic delays, emergency department length of stay, and the need for additional imaging. citeturn0search2

The article focuses on the sonographic assessment of splanchnic arteries and the bowel wall using high-resolution transabdominal ultrasound. It highlights the ability of color Doppler imaging to evaluate vascularity in gastrointestinal disorders like Crohn's disease, ischemia, and mesenteric artery stenosis. The study emphasizes the role of combining pulsed Doppler scanning with color Doppler to enhance accuracy in assessing splanchnic blood flow and bowel wall condition.

The article discusses the use of sonography to detect both normal and abnormal appendices. It highlights that sonography is highly sensitive (93%) and specific (94%) for detecting acute appendicitis. The study also shows that the normal appendix can be visualized in 82% of patients without acute appendicitis.

The article discusses the selective use of ultrasonography for detecting pneumoperitoneum, comparing it to traditional radiography. It highlights that ultrasound offers higher sensitivity and accuracy, making it a useful tool for detecting pneumoperitoneum in suspected cases. The study suggests that ultrasound may be more reliable than radiography for this purpose.

The article compares ultrasonography (US) and plain radiography for diagnosing pneumoperitoneum. It found that US had higher sensitivity (92% vs. 78%) and accuracy (88% vs. 76%) than plain radiography. However, both methods had similar specificity (53%) and positive predictive value (95% vs. 94%).

The article discusses the use of point-of-care ultrasound (POCUS) for the rapid diagnosis of intussusception in children. It highlights that POCUS is a highly effective diagnostic tool in the pediatric setting, enabling quick detection and reducing the need for more invasive procedures. The study shows that POCUS can aid in the timely management of intussusception, improving patient outcomes.

The article discusses the use of point-of-care ultrasound (US) in diagnosing intussusception in a pediatric emergency department. The diagnosis was confirmed through ultrasound, highlighting the effectiveness of bedside US in detecting intussusception quickly. This approach can help reduce the need for surgical intervention and ensure timely treatment.

The study "Value of Focused Appendicitis Ultrasound and Alvarado Score in Predicting Appendicitis in Children: Can We Reduce the Use of CT?" assessed the effectiveness of combining focused appendicitis ultrasound (FAUS) with the Alvarado score to diagnose appendicitis in children, aiming to reduce unnecessary CT scans. The research involved 522 children with suspected appendicitis, finding that FAUS provided conclusive results in 25.2% of cases, while 74.7% had inconclusive findings. Among those with inconclusive FAUS and a low Alvarado score (less than 5), only 0.3% were diagnosed with appendicitis, indicating a high negative predictive value (NPV) of 99.6% and supporting the safe avoidance of CT scans in these patients. citeturn0search0

The article "Diagnosis of Diverticulitis by Bedside Ultrasound in the Emergency Department" discusses the use of bedside ultrasound (US) for diagnosing diverticulitis in emergency settings. It highlights the "pseudo-kidney" sign observed on rapid, bedside ultrasound, which was confirmed by computed tomography (CT) in a patient with suspected diverticulitis. The study suggests that bedside US can be a valuable tool for initial assessment of diverticulitis in emergency departments. citeturn0search0

The article "Recognition of Pneumoperitoneum Using Bedside Ultrasound in Critically Ill Patients Presenting with Acute Abdominal Pain" discusses the use of point-of-care ultrasound (POCUS) to detect pneumoperitoneum in emergency department (ED) patients. It highlights the "Enhanced Peritoneal Stripe Sign" (EPSS), which involves identifying focal hyperechogenic thickening of the peritoneum with associated posterior dirty shadowing and/or horizontal reverberation artifacts. The study emphasizes that POCUS can assist emergency physicians in the rapid bedside diagnosis of perforated viscus and pneumoperitoneum, leading to early detection and timely management. citeturn0search0

The article "Hepatorenal Syndrome or Hepatocardiorenal Syndrome: Revisiting Basic Concepts in View of Emerging Data" examines the complex interplay between the liver, heart, and kidneys in patients with advanced cirrhosis. It highlights the often-overlooked role of cardiac dysfunction in contributing to circulatory abnormalities observed in hepatorenal syndrome (HRS). The authors propose that systemic inflammation and endothelial dysfunction are significant factors in the pathogenesis of HRS, suggesting a more integrated approach to understanding and treating this condition. citeturn0search0

The study found that body mass index (BMI) is not a reliable predictor of the success or accuracy of bedside ultrasound (BUS) in diagnosing appendicitis. Despite BMI categorization, ultrasound effectiveness was primarily influenced by factors like operator skill and patient anatomy rather than BMI. This suggests that other considerations should be prioritized when using BUS for appendicitis diagnosis.

The study compares clinical outcomes of obese and normal-weight children undergoing ultrasound for suspected appendicitis. It found that although obese children had similar hospitalization rates, length of stay, and complications as normal-weight children, they were more likely to undergo CT scans. Overall, both groups had comparable outcomes, suggesting ultrasound is effective in diagnosing appendicitis, but obese children may require more imaging.

The article discusses the diagnostic approaches and treatment options for appendicitis and diverticulitis. Appendicitis typically requires surgery (appendectomy), while diverticulitis can often be treated conservatively with antibiotics and supportive care unless complications arise. Imaging techniques, such as CT scans and ultrasounds, are vital for accurate diagnosis in both conditions.

The article on intussusception in children focuses on the condition where a part of the intestine folds into itself, leading to obstruction. Diagnosis is typically made using ultrasound, which can reveal a "target" or "doughnut" appearance. Treatment usually starts with a non-surgical contrast enema, and if unsuccessful or complications arise, surgical intervention is required for reduction.

The systematic review and meta-analysis titled "Accuracy of Point-of-care Ultrasonography for Diagnosing Acute Appendicitis" evaluated the diagnostic performance of point-of-care ultrasound (POCUS) in detecting acute appendicitis. The study found that POCUS demonstrated high sensitivity (91%) and specificity (97%) for diagnosing appendicitis. However, the authors caution that due to significant heterogeneity among studies and variability in operator experience, POCUS should be used as an initial screening tool, with further imaging or clinical evaluation as needed. citeturn0search0

The article "Sonography in the Evaluation of Acute Appendicitis" examines the effectiveness of ultrasound in diagnosing acute appendicitis, highlighting its high negative predictive value (NPV) and recommending it as a reasonable screening tool. The study found that sonography has a high NPV and should be considered as a reasonable screening tool in the evaluation of acute appendicitis. Additionally, the research suggests that further imaging could be performed if clinical signs and symptoms worsen.

The article on bowel obstructions in older children discusses the common causes of obstruction, such as adhesions, hernias, and intussusception. Symptoms typically include abdominal pain, vomiting, and constipation, and the condition is diagnosed using imaging techniques like x-rays, ultrasounds, or CT scans. Treatment ranges from conservative management (e.g., nasogastric decompression) to surgical intervention, depending on the severity and cause of the obstruction.

The study "Accuracy of Noncompressive Sonography of Children with Appendicitis According to the Potential Positions of the Appendix" evaluated the effectiveness of noncompressive sonography in diagnosing appendicitis in children by examining various potential positions of the appendix. The research involved 425 children with suspected appendicitis, utilizing a 5.0-MHz curved-array transducer to assess deep layers and systematically investigate possible appendix locations, including the right retrocecal region, pelvis, and right lower quadrant. The findings indicated that noncompressive sonography accurately identified 31.7% of appendicitis cases, and when combined with compressive techniques, the diagnostic accuracy improved significantly, achieving a sensitivity of 98.5% and specificity of 98.2%. citeturn0search0

The article presents the American College of Radiology (ACR) Appropriateness Criteria® for the evaluation of right lower quadrant pain with suspected appendicitis. It outlines evidence-based guidelines for imaging strategies, with a focus on prioritizing ultrasound as the first-line imaging modality due to its non-invasive nature and lack of radiation. If ultrasound results are inconclusive, the guidelines recommend using computed tomography (CT) as a secondary option, especially in complex cases, to improve diagnostic accuracy and guide appropriate treatment for appendicitis.

The article discusses the role of Continuing Medical Education (CME) activities in academic emergency medicine, emphasizing their importance in maintaining clinical competence, improving patient care, and keeping healthcare professionals updated with evolving medical practices. CME programs often include workshops, simulations, conferences, and online learning modules tailored to address advancements in emergency medicine. The study highlights the need for structured, evidence-based CME initiatives to ensure ongoing professional development, enhance critical decision-making skills, and promote better clinical outcomes in emergency care settings.

The article examines the accuracy of noncompressive sonography in diagnosing appendicitis in children, focusing on the different potential positions of the appendix. It finds that noncompressive ultrasound is an effective diagnostic tool, with accuracy varying depending on the appendix's location within the abdomen. The study emphasizes that understanding the potential positions of the appendix is critical for improving the sensitivity of ultrasound in detecting appendicitis, and suggests that tailored imaging approaches based on these positions can enhance diagnostic outcomes in pediatric patients.

The article highlights the use of ultrasound to detect small bowel obstruction (SBO) when traditional radiographic methods, such as X-rays, fail to provide clear results. Ultrasound is shown to be effective in visualizing dilated bowel loops, fluid accumulation, and lack of peristalsis, which are key indicators of SBO. The study suggests that ultrasound can be a valuable tool in cases where radiographic imaging is inconclusive, offering a non-invasive and accessible alternative for diagnosing SBO, particularly in the emergency setting.

The article explores the benefits of using point-of-care ultrasound (POCUS) as the first-line imaging tool for evaluating small bowel obstruction (SBO). The study finds that implementing a POCUS-first approach leads to significant national cost savings, reduced length of hospital stays, and decreased preventable radiation exposure by minimizing reliance on CT scans. The findings support the adoption of POCUS in emergency and clinical settings, as it offers a rapid, non-invasive, and cost-effective solution for diagnosing SBO while enhancing patient safety by reducing radiation exposure.

The article evaluates an interdisciplinary initiative designed to reduce radiation exposure in diagnosing appendicitis in pediatric patients. The initiative involves a staged approach combining clinical assessment with ultrasound as the first-line imaging tool, followed by computed tomography (CT) only if necessary. Results indicate that this pathway significantly reduces the use of CT scans, minimizing radiation exposure while maintaining diagnostic accuracy, ultimately improving patient safety and encouraging more conservative use of imaging resources in pediatric emergency departments.

The article investigates the role of abdominal wall thickness and appendiceal location in the ultrasound (US) depiction of the appendix. It highlights that a thicker abdominal wall can make it more challenging to visualize the appendix clearly using ultrasound, particularly in obese patients. The study emphasizes that understanding the relationship between these factors and the appendiceal location is crucial for improving the accuracy of ultrasound in diagnosing appendicitis, and it suggests that specific techniques or adjusted imaging angles may enhance visualization.

The article focuses on the use of abdominal ultrasonography for evaluating the pediatric gastrointestinal (GI) tract. It emphasizes that ultrasound is a safe, non-invasive, and effective imaging tool for diagnosing various pediatric GI conditions, such as appendicitis, intussusception, and inflammatory bowel disease. The study also highlights the advantages of ultrasound over other imaging techniques, including its ability to provide real-time results, avoid radiation exposure, and aid in guiding treatment decisions for pediatric patients.

The article discusses the significance of abdominal ultrasound in diagnosing and monitoring inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis. Ultrasound is highlighted as a valuable, non-invasive imaging technique that can assess disease activity, detect complications such as bowel wall thickening or abscesses, and guide treatment decisions. The study emphasizes the role of ultrasound in IBD management, offering an alternative to more invasive procedures like endoscopy or CT scans, with the added benefit of avoiding radiation exposure.

The article by Jae Lim discusses the diagnosis and management of intestinal obstruction, focusing on causes, clinical presentation, and treatment options. It highlights the importance of early detection through imaging techniques such as X-ray, CT scans, and ultrasound, which help assess the severity and location of the obstruction. The article emphasizes that timely surgical or conservative intervention based on the type and cause of obstruction is crucial for improving patient outcomes.

The article explores the role and contribution of sonography in diagnosing small bowel obstruction (SBO). Ultrasound is highlighted as a non-invasive, readily available imaging technique that can effectively identify key signs of SBO, such as bowel dilation, fluid-filled loops, and absent peristalsis. The study emphasizes that sonography can assist in the initial diagnosis, guide treatment decisions, and reduce the need for more invasive imaging methods like CT scans, making it an essential tool in the management of SBO.

The article examines the use of ultrasonography by emergency medicine and radiology residents to diagnose small bowel obstruction (SBO). The study finds that with proper training, residents in both specialties can effectively use ultrasound to identify key indicators of SBO, such as dilated loops of bowel and absent peristalsis. This approach improves diagnostic accuracy, reduces reliance on more invasive imaging methods, and can expedite patient management in the emergency setting.

The article discusses the use of bedside ultrasonography for detecting small bowel obstruction (SBO) in the emergency department. Findings show that ultrasound is a highly effective, noninvasive tool for diagnosing SBO, providing real-time visualization of bowel dilation, fluid-filled loops, and absent peristalsis. The study highlights that bedside ultrasound can help emergency physicians quickly diagnose SBO, facilitating faster treatment decisions and reducing the need for more invasive imaging techniques like CT scans.