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Fig. 8 | World Journal of Emergency Surgery

Fig. 8

From: Diagnostic point-of-care ultrasound (POCUS) for gastrointestinal pathology: state of the art from basics to advanced

Fig. 8

A 60-year old man who had atrial fibrillation developed abdominal pain of 24 h duration. He had a distended tender abdomen. Bowel sounds were negative. POCUS (a) was done using small print convex array probe (3–5 MHz). It was unexpectedly difficult because of obesity and unusual abdominal reverberation artefacts (arrowheads). The ileum (IL) was dilated and non-active. The high-frequency linear probe (10–12 Mhz) (b) confirmed these findings and detected gas within the bowel wall shown as tiny white dots (white arrows). CT angiography scan (c) showed superior mesenteric artery occlusion with massive bowel ischaemia. The small bowel loops had non-enhancing walls and pneumatosis intestinalis (yellow arrows). There was massive gas in the mesenteric vessels (white arrow). Laparotomy confirmed these findings (d). Clinical image, Courtesy of Dr Hussam Mousa, Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates

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