Point-of-care ultrasound as the first imaging strategy in young infants aged under 90 days presenting with gastrointestinal manifestations at the emergency department

This study compared the emergency department (ED) flow of young infants under 90 days old presenting with gastrointestinal symptoms who underwent point-of-care ultrasound (POCUS) versus X-ray (XR) as their primary imaging test. The study retrospectively enrolled infants under 90 days old with gastrointestinal (GI) symptoms who visited a tertiary university-affiliated hospital ED from January 2019 to September 2022. The patients were divided into 2 groups based on whether they received XR or POCUS as their first imaging test. Out of 440 patients, 352 (80%) were enrolled in the XR-first group and 88 (20%) in the POCUS-first group. No significant differences exist in demographics, clinical characteristics, or the prevalence of surgical abdomen between the groups. The time-to-disposition and ED length of stay (EDLOS) were significantly shorter in the POCUS-first group as compared to those in the XR-first group (86 min vs 127 min, P = .013; 121 min vs 157 min, P = .049; respectively). In the POCUS-first group, only 30.7% of the cases required an additional XR. The performance of POCUS in screening for surgical abdomen showed a sensitivity and specificity of 95.8% and 95.3%, respectively. In young infants under 90 days presenting with GI symptoms at the ED, using POCUS as the first imaging test instead of XR can shorten time-to-disposition and EDLOS, improving ED flow with acceptable screening performance for surgical emergencies.