HPI: 60 yo male with PMH of cerebral palsy, hx of SBO s/p resection and PEG tube presented to ED for vomiting.
POCUS showed:
Note the to and fro peristalsis. Usually bowel is not visualized this well on POCUS due to air artifact. This, in itself, is a sign of surrounding edema and fluid filled structures.
Note that this is small bowel because of the “keyboard” sign representing plicae circulares (vs haustra seen in large bowel)
SBO POCUS findings:
3 dilated small bowel loops >2.5 cm
To and fro peristalsis
Bowel wall edema >3 mm
Free fluid (previously known as “tanga sign”)
Case conclusion: Patient was admitted to surgical service for management of SBO!
Happy Scanning!
The US Team