Utilization of bedside urogenital ultrasound in an austere combat setting: enterovesicular fistula case report

• Published in: Military medicine Vol. 178; no. 3; pp. e376 - e379
• Main Authors: Lunceford, Nicole, Scherl, Robert J, Elliot, Jonathan, Bechtel, Brett F, Auten, Jonathan
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.03.2013
• Subjects: Abdomen; Adult; Bladder; Blood tests; Case reports; Colon - diagnostic imaging; Colonoscopy; Crohn Disease - complications; Crohn Disease - diagnosis; Crohns disease; Diagnosis, Differential; Emergency medical care; Fistula; Health facilities; Hematuria; Humans; Hydronephrosis; Intestinal Fistula - diagnostic imaging; Intestinal Fistula - etiology; Kidney stones; Kidneys; Male; Medicine; Metabolism; Pain; Pathology; Point-of-Care Systems - utilization; Tomography, X-Ray Computed; Ultrasonic imaging; Ultrasonography; Urinalysis; Urinary Bladder - diagnostic imaging; Urinary Fistula - diagnostic imaging; Urinary Fistula - etiology; Urogenital system; Vital signs; United States > US
• ISSN: 0026-4075; 1930-613X
• DOI: 10.7205/MILMED-D-12-00320

The role of bedside ultrasound by physicians with advanced ultrasound training, such as emergency medicine providers, has been clearly established in the austere setting of combat medicine. This highly mobile, noninvasive, and versatile imaging modality has a role in evaluating battle- and nonbattle-related presentations. This case report describes a U.S. Marine reporting to an austere medical facility with the chief complaint of abdominal pain. An ultrasound of the patient's urinary tract revealed abnormalities that suggested right bladder wall thickening and an echo dense layer of sediment as the potential source of his discomfort. These findings supported patient transfer to a higher echelon of care. Further diagnostic testing revealed Crohn's disease with an associated enterovesicular fistula.