Point-of-Care Gastric Ultrasound–Guided Nasogastric Decompression in a Fasting Patient With Prior Aspiration: A Case Report

Pulmonary aspiration remains a serious perioperative complication, and fasting status alone may not reliably predict gastric contents in patients with delayed gastric emptying. We describe the use of gastric point-of-care ultrasound (POCUS)-guided assessment of retained gastric contents and attempted risk mitigation with nasogastric decompression in a fasting patient with a history of large-volume regurgitation during procedural sedation. Gastric POCUS may assist in risk stratification when gastric emptying is uncertain. However, even after decompression, aspiration risk is not eliminated, as residual or recurrent gastric contents may persist, requiring continued individualized assessment and vigilance.