Bedside ultrasonography with nasogastric air insufflation for diagnosis of non-free air peptic ulcer perforation : A Pilot Study

Abstract

          Background: Non-free air peptic ulcer perforation is an urgent condition. However, diagnosing confirmation requires an expensive computerized tomography and is time-consuming

          Objectives: To study results of bedside ultrasonography and nasogastric air insufflation for helping diagnose non-free air peptic ulcer perforation and develop guidelines to diagnose non-free air peptic ulcer perforation

          Methods: A Quasi-experimental pilot study in suspected patients of peptic ulcer perforation without non-free air in Nongbualamphu hospital between 1 January – 31 December 2021. All of them receive bedside ultrasonography and then perform nasogastric air insufflation before taking a chest X-ray. If one of the methods is confirmed peptic ulcer perforation the patient will have surgery but if both methods do not confirm peptic ulcer perforation the patient will admit and supportive treatment until discharge.

          Result: There were 56 patients who suspect non-free air peptic ulcer perforation. There were 49 patients (87.5%) who did not found peptic ulcer perforation. There were 6 patients (10.7%) who confirm diagnostic peptic ulcer perforation by ultrasonography. There were 7 patients (12.5%) who confirm diagnostic peptic ulcer perforation by nasogastric air insufflation.  All 7 patients (12.5%) patients had surgery and confirmed founding peptic ulcer perforation.

          Conclusion: Bedside ultrasonography and nasogastric air insufflation can be useful diagnosis of non-free air peptic ulcer perforation and reduce used of abdominal computerized tomography.