01 Jan 2018 Courtesy of Madi Lindauer

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Presentation transcript:

01 Jan 2018 Courtesy of Madi Lindauer IOTW 01 Jan 2018 Courtesy of Madi Lindauer

Case 36 yo F presents to ED for abdominal pain. Abdominal pain is located in the RUQ and LLQ. Associated with one episode of diarrhea in the morning and emesis. ED team requested a RUQ sono to assess for biliary pathology During the exam, the patient asked “ Can you look here where it’s REALLY hurting?” and pointed to LLQ

LLQ

Did you Notice the Dilated loops? Or the thickened Bowel wall? Plicae Circulares 2.89 cm 0.46 cm

NOTICE THE “TO AND FRO”

Small Bowel Obstruction On Ultrasound? Signs of? Small Bowel Obstruction On Ultrasound?

Criteria of SBO dilated bowel loop (diameter > 2.5 cm) bowel wall thickening > 3mm fluid-filled distended bowel with extra luminal free fluid between bowel loops Back and forth peristalsis May see transition point

What happened to the patient: Patient was found to have an SBO on CT scan. She went to the OR for an emergent ex-lap and was found to have frank pus in her abdomen without any signs of perforation.