Gastrointestinal Ultrasound (GIUS) in Intestinal Emergencies - An EFSUMB Position Paper
Por:
Hollerweger A, Maconi G, Ripolles T, Nylund K, Higginson A, Serra C, Dietrich CF, Dirks K and Gilja OH
Publicada:
1 dic 2020
Ahead of Print:
20 abr 2020
Resumen:
An interdisciplinary group of European experts summarizes the value of gastrointestinal ultrasound (GIUS) in the management of three time-critical causes of acute abdomen: bowel obstruction, gastrointestinal perforation and acute ischemic bowel disease. Based on an extensive literature review, statements for a targeted diagnostic strategy in these intestinal emergencies are presented. GIUS is best established in case of small bowel obstruction. Metanalyses and prospective studies showed a sensitivity and specificity comparable to that of computed tomography (CT) and superior to plain X-ray. GIUS may save time and radiation exposure and has the advantage of displaying bowel function directly. Gastrointestinal perforation is more challenging for less experienced investigators. Although GIUS in experienced hands has a relatively high sensitivity to establish a correct diagnosis, CT is the most sensitive method in this situation. The spectrum of intestinal ischemia ranges from self-limited ischemic colitis to fatal intestinal infarction. In acute arterialmesenteric ischemia, GIUS may provide information, but prompt CT angiography is the gold standard. On the other end of the spectrum, ischemic colitis shows typical ultrasound features that allow correct diagnosis. GIUS here has a diagnostic performance similar to CT and helps to differentiate mild from severe ischemic colitis.
Filiaciones:
Hollerweger A:
Department of Radiology, Hospital Barmherzige Brüder, Salzburg, Austria
Maconi G:
Gastroenterology Unit, Department of Biomedical and Clinical Sciences, "L.Sacco" University Hospital, Milan, Italy
:
Department of Radiology, Hospital Universitario Doctor Peset, Valencia, Spain
Nylund K:
Gastroenterology, Haukeland University Hospital, Bergen, Norway
Higginson A:
Department of Radiology, Queen-Alexandra-Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom of Great Britain and Northern Ireland
Serra C:
Internal Medicine and Gastroenterology, S. Orsola University Hospital, Bologna, Italy
Dietrich CF:
Department of General Internal Medicine Kliniken Hirslanden Beau-Site, Salem und Permanence, Bern, Switzerland
Dirks K:
Gastroenterology and Internal Medicine, Rems-Murr-Klinikum Winnenden, Germany
Gilja OH:
Haukeland University Hospital, National Centre for Ultrasound in Gastroenterology, Bergen, Norway
Bronze, Green Published
|