Preoperative Assessment of Ultrasonographic Measurement of Antral Area for Gastric Content

Med Sci Monit. 2018 Aug 9:24:5542-5548. doi: 10.12659/MSM.908520.

Abstract

BACKGROUND Pulmonary aspiration of the gastric contents is a serious perioperative complication. The aim of this study was to evaluate the efficacy of portable ultrasonography in the preoperative evaluation of the gastric contents of patients. The secondary aim was to examine the relationship between gastric antrum cross-sectional area and age and body mass index (BMI). MATERIAL AND METHODS This single-center, prospective, cross-sectional study included 120 patients who underwent surgery. Measurements the gastric antral cross-sectional areas and quantitative and qualitative measurements of the stomach were taken by ultrasonography guidance in all patients. RESULTS With the patient in a supine position, the mean gastric antrum cross-sectional area was found to be 3.4±2.43 cm² (range, 0.79-17.3 cm²). As the number of hours of fasting increased, the gastric antral cross-sectional area statistically significantly decreased (P<0.05). Increased age and BMI values were determined to increase the gastric antrum cross-sectional area in a linear correlation; r=0.209, P<0.05 and r=0.252, P=0.05, respectively. It was determined that 20.8% of the patients exceeded the high-risk stomach antral cutoff cross-sectional area that was defined as 340 mm2 in patients fasting for at least 8 hours. CONCLUSIONS It was determined that bedside ultrasonography is a useful, non-invasive tool in the determination of gastric content and volume. A significant proportion of surgical patients may not present with an empty stomach despite the recommended fasting protocols.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Cross-Sectional Studies
  • Female
  • Gastric Emptying / physiology
  • Gastrointestinal Contents / diagnostic imaging*
  • Humans
  • Intraoperative Complications / prevention & control*
  • Male
  • Middle Aged
  • Preoperative Care / methods
  • Prospective Studies
  • Pyloric Antrum / anatomy & histology
  • Pyloric Antrum / diagnostic imaging*
  • Stomach / diagnostic imaging
  • Ultrasonography / methods