Q: Can a quick ultrasound save an UGI contrast series?

A bit of greenish vomiting, not feeding so well and some concern that the newborn in front of you has volvulus. So do you really need to go through the hassle and pain of organising a contrast upper GI series, especially as the parents are already worried about getting feeding established, or could normally placed vessels on an abdominal USS help you out?I think this is a classic Bayesian dilemma … even if the USS occasionally misses ones because of bowel gas, wiggly babies or the wrong kind of cloud formation on the screen … if you were only mildly suspicious in the first place does a non-positive USS do enough of a ruling out?

Any thoughts?

Acknowledgements: Photo from NZ teaching site

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