Gastric Point-of-Care Ultrasound Diagnosis of Unexpected Gastrointestinal Dysfunction During ICU Ward Rounds: A Case Report

BACKGROUND Point-of-care ultrasound (POCUS) is increasingly used as an extension of the physical examination during daily intensive care unit (ICU) rounds and has become a valuable bedside diagnostic tool. Gastric POCUS, in particular, offers a noninvasive method to evaluate gastric content and motility, and to identify patients at risk for impaired gastric emptying. Such dysfunction can lead to aspiration, delayed enteral feeding, and challenges in procedural planning or sedation. As the use of POCUS continues to expand in critical care practice, its gastrointestinal applications show increasing clinical relevance. CASE REPORT We describe a 50-year-old male patient admitted to the ICU with suspected cytokine release syndrome and possible coinfection. During hospitalization, he developed a progressive decline in consciousness, prompting plans for brain magnetic resonance imaging (MRI). Despite stable hemodynamic and respiratory status, a routine pre-transport POCUS assessment was performed. Gastric POCUS revealed a markedly distended gastric antrum with clear fluid mixed with gastric contents, corresponding to an antral grade 2 appearance and indicating a high residual gastric volume. Based on these findings, a nasogastric tube was placed for gastric decompression, the MRI was postponed, and triple prokinetic therapy was initiated. These interventions were implemented promptly at the bedside, demonstrating the role of gastric POCUS in real-time clinical decision-making. CONCLUSIONS This case underscores the value of gastric POCUS in detecting gastrointestinal dysfunction and preventing complications such as aspiration in ICU patients. Routine gastric ultrasonography may enhance patient safety and guide management during critical care evaluations.