Obligatory medical device diagnostics.
- Abdominal ultrasonography (ultrasonography of abdominal organs) – as a standard diagnostic tool for abdominal pain (abdominal pain); because of distended abdomen, abdominal ultrasonography is usually of secondary importance [free fluid?, incarcerated hernia?]
- Small bowel ileus [fluid-filled luminal dilation (> 25 mm); “ladder sign” on lateral/lateral sonication]
- X-ray of the abdomen (X-ray abdomen; abdominal overview as a blank image) – in the clinically stable patient without serious symptoms and lack of signs of infection Implementation: if an image in the standing position is not possible for the patient, an X-ray overview should be performed in the left lateral position after 15- to 20-minute positioning.[Mirror formation? ; Specificity (probability that actually healthy people who do not suffer from the disease in question, are also detected as healthy in the test) of up to 74% in the diagnosis of ileus;detection of free air? then the procedure is more sensitive than standing (96% versus 85%)].
- Application of 100 ml of water-soluble, iodine-containing contrast medium via an inserted stomach tube – if incomplete ileus is suspected [If the contrast medium has reached the colon within 24 h, a sensitivity of 96 % and a specificity of 98 % can predict successful conservative therapy (level of evidence: 1a).
- Computed tomography (CT) of the abdomen (abdominal CT) with oral and intravenous contrast – detection of the cause of obstruction [gold standard; sensitivity and specificity > 90%]In addition to the severity, location, and cause of ileus, possible complications (perforation, ischemia) can also be determined.
- Colonoscopy (colonoscopy) – Indications:
Optional medical device diagnostics – depending on the results of the history, physical examination and mandatory laboratory parameters – for differential diagnostic clarification.
- Electrocardiogram (ECG; recording of the electrical activity of the heart muscle) – to exclude myocardial infarction (heart attack).
- X-ray of the pelvis – if urinary stones are suspected.
- X-ray of the thorax (X-ray thorax/chest), in two planes – if pneumonia is suspected.
- X-rays of the spine, ribs – if bony cause is suspected.
- Pulmonary function examination – if pulmonary disease is suspected in obstructive or restrictive lung disease.
- Gastroscopy (gastroscopy) – for suspected diseases of the esophagus (esophagus), stomach.
- Endosonography (endoscopic ultrasound (EUS); ultrasound examination performed from the inside, i.e., the ultrasound probe is brought into direct contact with the internal surface (for example, the mucosa of the stomach/intestine) by means of an endoscope (optical instrument)). – In cases of suspected diseases of the esophagus (esophagus), stomach.
- Endoscopic retrograde cholangiopancreatography (ERCP) – imaging of the bile ducts in suspected gallstones.
- Echocardiography (echo; cardiac ultrasound) – if pericarditis (inflammation of the pericardium) is suspected.
- Urography or retrograde pyelography – if urinary stones are suspected.
- Computed tomography of the thorax/chest (thoracic CT) – if pulmonary embolism, mediastinitis (inflammation of the midfield) is suspected.
- Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging method (using magnetic fields, i.e., without X-rays)) of the spine (spinal MRI) – for suspected discopathies (disc lesions) or nucleus pulposus prolapse (herniated disc).
