RecruitingOBSERVATIONAL

Contribution of Point of Care Ultrasound by the Emergency Physician to Rule Out the Small Bowel Obstruction: a Diagnostic, Multicenter Study

Doctors in A&E often see patients with a suspected small bowel blockage. Currently, a CT scan is used to confirm this, but CT scans involve radiation, cost money, and can lead to longer waits. This study aims to see if a quick ultrasound, performed by the emergency doctor, can effectively rule out a small bowel blockage in certain patients. Specifically, it focuses on patients who doctors think have a low or medium chance of having a blockage. If successful, this could mean fewer patients need a CT scan, reducing their exposure to radiation, cutting costs, and shortening A&E wait times. The study will perform both the ultrasound and a CT scan (the usual method) to compare their results.

At a glance

Status

Recruiting

Sponsor

Nantes University Hospital

Enrolment target

667

Start

10 Mar 2025

Estimated completion

10 Mar 2027

Small Bowel Obstruction

What is this study about?

Imagine you come to A&E with tummy pain, sickness, or other symptoms that make doctors wonder if you have a small bowel blockage. This is a common problem, and currently, the main way to find out for sure is to have a CT scan. A CT scan is excellent for seeing what's going on inside your body, but it does expose you to radiation. It also costs money and can mean you spend more time waiting in A&E.

Researchers are exploring a different approach: using a quick ultrasound scan, performed by the emergency doctor right there in A&E. This type of ultrasound, called Point of Care Ultrasound (POCUS), has shown promise in other studies for being quite good at spotting or ruling out a bowel blockage. The idea is to see if POCUS can be used as a 'rule-out' tool, especially for patients who the doctor initially believes have a low or medium chance of having a blockage.

This study wants to show that if a patient is at low or moderate risk of a bowel blockage and their POCUS scan looks normal, then they probably don't have a blockage, meaning they might not need a CT scan. This could lead to a faster diagnosis, less radiation exposure for patients, and free up CT scanners for those who really need them. The study will involve doing both a POCUS scan and a CT scan on participants to compare how well the POCUS works against the established CT scan results.

Key takeaways

This study evaluates if a quick ultrasound can help rule out bowel blockages in A&E.
It aims to reduce the need for CT scans, which use radiation and take longer.
Participation involves having both an ultrasound and a CT scan.
Only patients with a low or moderate risk of blockage can join.
The study could lead to faster diagnoses and reduced radiation exposure.
Your medical care won't change if you participate.

Who may be eligible?

This study is looking for adults aged 18 or over who come to the emergency department with symptoms that could suggest a small bowel blockage. This includes symptoms like tummy pain, being sick, or not being able to pass wind or stools. Importantly, the emergency doctor must also think there's a low or moderate (medium) chance that you have a bowel blockage.

You need to be able to understand what the study involves and agree to take part. You also need to speak and understand French, as the study is taking place in a French hospital. You must have health insurance to cover your care.

Some people can't join the study, such as those who are under legal guardianship, are pregnant or breastfeeding. Also, if you've already had imaging that confirmed a bowel blockage, or if you're taking part in another study about tummy pain that involves CT or ultrasound scans, you won't be able to participate in this one.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Am I 18 years old or older?
Am I in A&E with symptoms like tummy pain or being sick?
Has the doctor told me they think I'm at low or medium risk of a bowel blockage?
Do I speak and understand French?
Do I have health insurance?
Am I not pregnant or breastfeeding, and not under legal guardianship?

Answer every question to see your result.

What does participation involve?

If you decide to take part in this study, the process is straightforward. First, an emergency doctor will perform a quick ultrasound scan of your tummy right there in the A&E department. This is a common and painless procedure where a small handheld device is moved over your skin. Following this, you will still undergo a CT scan of your abdomen, which is the standard procedure for suspected bowel blockages. Both the ultrasound and the CT scan are part of your usual care, but for the study, the results will be carefully compared. There are no extra visits or medications involved specifically for the study. The total duration of your participation will be limited to the time you spend in the A&E department for these scans and immediate assessments.

Potential risks and benefits

Participating in this study will not change the medical care you receive, as you will still have both the ultrasound and the CT scan, which are part of the standard process for your condition. A potential benefit could be helping researchers understand if a quick ultrasound can safely reduce the need for CT scans in the future for certain patients, which would mean less radiation exposure and shorter waits in A&E. The main risk is that the ultrasound might miss a blockage, but this study carefully compares it against a CT scan to ensure accuracy. You are free to withdraw from the study at any time without affecting your medical care.

Locations (18)

Chu Clermont-Ferrand Hopital Gabriel Montpied
Verified postcode
Clermont-Ferrand, France· Recruiting
Ghem Groupe Hospitalier Eaubonne Montmorency Simone Veil
Verified postcode
Eaubonne, France· Recruiting
CHD Vendée
Verified postcode
La Roche-sur-Yon, France· Recruiting
CHD Vendée, Luçon
Verified postcode
Luçon, France· Recruiting
Ap-Hm Hopital La Timone
Verified postcode
Marseille, France· Recruiting
Hôpital Nord
Verified postcode
Marseille, France· Withdrawn
Ghsif Groupe Hospitalier Sud Ile de Franc _ Ch Melun
Verified postcode
Melun, France· Recruiting
CHD Vendée, Montaigu
Verified postcode
Montaigu, France· Recruiting
CHU Nantes
Verified postcode
Nantes, France· Recruiting
Le Confluent
Verified postcode
Nantes, France· Recruiting
CHU CAREMEAU - Nimes
Verified postcode
Nîmes, France· Recruiting
AP-HP Est Parisien _ ST-ANTOINE
Verified postcode
Paris, France· Recruiting

Common questions

What is a small bowel blockage?

It's when something is blocking your small intestine, stopping food and waste from passing through. This can cause tummy pain, sickness, and other symptoms.

What is a Point of Care Ultrasound (POCUS)?

It's a quick ultrasound scan done by a doctor at your bedside, like in the emergency department, to get immediate information.

Why is this study important?

It could help find a quicker and safer way to check for bowel blockages, potentially reducing the number of people who need CT scans, which involve radiation.

Will I still get a CT scan if I join the study?

Yes, you will still have a CT scan. The study is comparing how well the ultrasound works against the CT scan, which is the usual way to diagnose a blockage.

Does taking part affect my treatment?

No, your medical care and treatment will be exactly the same whether you join the study or not. Your doctors will still treat you based on your condition.

How to find out more

Philippe LE CONTE Professor LE CONTE, Professor

philippe.leconte@chu-nantes.fr 0240083934 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.