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Updated: Mar 18, 2026
Author Spotlight: Point-of-Care Ultrasound for Gastric Content Assessment and Risk Stratification in Perioperative Care
Published on: September 22, 2023
Normal Values and Clinical Use of Bedside Sonographic Assessment of Postoperative Gastric Emptying: A Prospective
Naseem Mirbagheri1, Graham Dunn, Vasikaran Naganathan
11 Academic Colorectal Unit, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia 2 Sydney Colorectal & Pelvic Floor Centre, Sydney, New South Wales, Australia 3 Department of Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia 4 Concord Clinical School, Centre for Education and Research on Ageing, Concord, New South Wales, Australia.
Background:
GI dysfunction is common after abdominal surgery. However, assessment and diagnosis currently lack objective measurement.
Objective:
The purpose of this study was to evaluate the feasibility and clinical use of bedside sonographic assessment of gastric emptying by measuring the time to complete emptying of a standard volume of ingested water in patients after colorectal surgery.
Design:
This was a prospective cohort study.
Settings:
The study was conducted at a single tertiary institution in Sydney.
Patients:
Healthy volunteers (n = 30) were studied to establish a reference range. Gastric emptying was then measured in patients (n = 39) before and after colorectal surgery.
Intervention:
Assessment of gastric emptying was performed on days 1 to 4 by measuring antral cross-sectional area every 10 minutes after ingestion of 250 mL of water.
Main Outcome Measures:
The time to complete emptying of water was used as a surrogate measure of gastric emptying. Information concerning postoperative outcomes, GI symptoms, and recovery was also recorded.
Results:
The median time to complete emptying of water for healthy volunteers was 20 minutes (range, 10-40 minutes). The study protocol was completed in 30 of 39 patients. The time to complete emptying of water on day 2 had the best discriminatory power to identify patients with ileus (sensitivity, 85.71%; specificity, 82.61%). Gastric emptying was normal in 20 of 30 (67%) patients, with only 1 case of ileus (false negative). These patients had less nausea (p = 0.0003), earlier intake of solid diet (p = 0.001), and shorter hospital stay (p = 0.040) compared with patients with abnormal gastric emptying.
Limitations:
Ultrasound is operator dependent with a learning curve.
Conclusions:
Bedside sonographic assessment of gastric emptying is feasible and reliable. Assessment of antral contents with a single ultrasound 40 minutes after ingestion of water enables classification of patients into those with normal and abnormal gastric emptying. When performed on postoperative day 2, it has good sensitivity/specificity for discriminating patients with ileus.
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