Benefits of Point-of-Care Ultrasound for Assessing Gastric Contents

Point-of-care ultrasound (POCUS) has emerged as a valuable bedside tool for assessment of gastric contents in perioperative and emergency settings. Accurate identification of gastric volume and composition is critical for estimating pulmonary aspiration risk, particularly when fasting history is unreliable or gastric emptying is impaired. Visualization of the gastric antrum enables qualitative grading and semiquantitative estimation of gastric volume, offering a practical alternative to traditional assessment methods.

An 85-year-old female with multiple comorbidities-including chronic obstructive pulmonary disease, heart failure, chronic kidney disease, and diabetes-presented with small bowel obstruction. Despite intrahospital fasting, preoperative gastric POCUS demonstrated substantial gastric contents consistent with a full stomach. Sedation was administered to facilitate nasogastric sump tube placement, resulting in effective gastric decompression. The patient underwent exploratory laparotomy with lysis of adhesions and ventral hernia repair without intraoperative complications or vasopressor requirement. Postoperatively, she was transferred to the surgical intensive care unit in stable condition. Given the patient's advanced age and cardiopulmonary comorbidities, ongoing management emphasized careful fluid balance and continued gastric decompression.

Gastric POCUS provides high diagnostic accuracy for detecting clinically significant gastric volumes associated with aspiration risk and maintains reliability across diverse patient populations. The ability of gastric POCUS to support dynamic, real-time decision-making enhances patient safety, informs airway management strategies, and improves perioperative workflow efficiency. Future advances, including artificial intelligence-assisted interpretation, are expected to further expand the role of gastric POCUS in anesthesia and critical care practice.