So your intubated patient has developed abdominal distension and residuals are 250. You scan the LUQ:

 

 

 

what do you see?  what should you do?

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You have gastric distension with at least a liter of fluid in there.   Put in an OG, hold feeds, assess the rest of the abdomen to r/o bowel obstruction, consider motility agents and look for a reason behind the ileus or obstruction.

 

 

Philippe