Point-of-Care Ultrasound to Diagnose Colitis in the Emergency Department: A Case Series and Review of the Literature |
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| Affiliation: | 1. Department of Emergency Medicine, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel;2. Department of Diagnostic Ultrasound, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel;3. Department of Emergency Medicine, Shaare Zedek Medical Center, Jerusalem, Israel;1. Department of Anesthesiology, Bnai Zion Medical Center, Haifa, Israel;2. Israel Faculty of Medicine, Technion, Israel-Institute of Technology, Haifa, Israel;3. Department of Surgery, Bnai Zion Medical Center, Haifa, Israel;4. Department of Anesthesia and Perioperative Medicine, Complejo Hospitalario Universitario de A Coruña, A Coruña, Galicia, Spain;6. Spanish Difficult Airway Group (GEVAD), Institute for Biomedical Research of A Coruña, A Coruña, Spain;5. Anesthesiology and Pain Management Research Group, Institute for Biomedical Research of A Coruña, A Coruña, Spain;1. Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts;2. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts;3. Department of Medicine, North Shore Medical Center, Salem, Massachusetts;1. Department of Emergency Medicine, Arrowhead Regional Medical Center, San Bernardino, California;2. ZOLL Medical Corporation, Chelmsford, Massachusetts;3. Air Methods Corporation, Englewood, Colorado;1. Department of Gastroenterology, Changhua Christian Hospital, Chienkuo Technology University Changhua, Changhua, Taiwan;2. General Education Center, Chienkuo Technology University Changhua, Changhua, Taiwan |
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| Abstract: | BackgroundColitis refers to an inflammatory process of the colon, composed of a variety of different etiologies including inflammatory bowel disease, infectious colitis, ischemic colitis, and allergic colitis. Usually, abdominal computed tomography (CT) is the gold standard in diagnosing the various forms of colitis. However, by the use of point-of-care ultrasound (POCUS), one may occasionally be able to discern wall thickening, pericolic fluid, and adjacent hyperechoic mesenteric fat. One may also see abscesses, fistulae, or ascites.Case SeriesThis is a series of 6 patients who had findings consistent with colitis seen on POCUS performed by an emergency physician. These were confirmed by abdominal CT with contrast. Early detection by POCUS was able to lead to a rapid diagnosis and to expedite treatment.Why Should an Emergency Physician Be Aware of This?The ability to detect findings of colitis by POCUS can be quickly learned by the emergency physician with a strong background in basic ultrasound. For many of the different subtypes of colitis, the initial treatment in the emergency department is the same: i.v. antibiotics, i.v. fluids, and “bowel rest” by maintaining the patient in nothing-by-mouth status. For the stable patient with high clinical suspicion of an infectious etiology of colitis, ultrasound can help confirm the diagnosis and rule out other etiologies. This may be especially important in certain populations such as children and young women, where one can avoid a significant amount of radiation being directed toward the pelvic area. |
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| Keywords: | colitis ultrasonography point-of-care ultrasound emergency department |
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