NCT06803628: OCCLUS-POCUS

Contribution of Point of Care Ultrasound by the Emergency Physician to Rule Out the Small Bowel Obstruction: a Diagnostic, Multicenter Study

Recruiting now Last updated 26 January 2026

What this trial tests

trial testing Point of care ultrasound in Small Bowel Obstruction in 667 participants. Currently enrolling.

Timeline

10 March 2025

Primary endpoint
10 March 2027

10 March 2027

Quick facts

Lead sponsor	Nantes University Hospital
Status	Recruiting now
Study type	OBSERVATIONAL
Enrollment	667
Start date	10 March 2025
Primary completion	10 March 2027
Estimated completion	10 March 2027
Sites	18 locations across France

Drugs / interventions tested

• Point of care ultrasound

Conditions studied

• Small Bowel Obstruction — all drugs for Small Bowel Obstruction →

Sponsor

Nantes University Hospital

Who can join

18 and older, any sex, with Small Bowel Obstruction. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Small Bowel Obstruction (SBO) is a frequent pathology in the emergency department (ED). Diagnosis is currently based on abdominal CT scan (CT). Moreover, CT is warranted to determine the therapeutic strategy in patients with SBO which could include medical treatment; surgical intervention or both. However, CT is associated with drawbacks such as radiation exposure, increased cost and ED length-of-stay.

In a prospective observational study, a SBO was excluded by CT in 45% \[95%CI: 37-53\] of patients. There is, thus, a need for improving the appropriateness of CT-scan for suspected SBO.

A recent meta-analysis showed that Point of care ultrasound (POCUS) had a good diagnostic accuracy (sensitivity 83% \[95%CI 71.7%-90.4%\]), specificity 93% \[95%CI 55.3%-99.3%\]). Another meta-analysis found rather similar results (sensitivity 83% \[(95% CI 89.0% to 94.7%\], specificity 96,6% \[95% CI 88.4% to 99.1%\]).

In order to improve the negative predictive value of POCUS for its implementation as a rule-out strategy, CHU of Nantes emergency unit studied the combination of POCUS with Gestalt pre-test probability of SBO determined by the emergency physician. This SBO probability classified the patients as low, moderate or high risk of SBO. In patients with low or moderate Gestalt probability, CHU of Nantes emergency unit found that this combined strategy had a sensitivity of 100% \[95% CI: 88-100\] and NPV 100% \[92-100%\].

By (i) focusing on patients with a low or moderate Gestalt clinical probability and (ii) increasing the number of patients included, CHU of Nantes emergency unit intends to demonstrate that POCUS is able to exclude SBO in this population. This would avoid unnecessary CT and thus lower costs, ED length-of-stay and hospital radiologists workload.

A POCUS will be performed followed by a CT (gold standard). The main objective will be the ability of POCUS to rule-out SBO in patients with low or moderate Gestalt clinical probability.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

1. Contribution of point of care ultrasound for ruling out small bowel obstruction in emergency departments: study protocol of the diagnostic, observational, prospective and multicentre OCCLUS-POCUS study.
   Papin M, Le Bastard Q, Saignes M, Le Thuaut A, et al · · 2026 · PMID 42209001 · DOI 10.1136/bmjopen-2025-113887