What question did this study set out to answer?

To explore the use of ultrasound in assessing preoperative gastric contents as a predictor of aspiration risk in surgical patients.

January 10, 2026Therapeutics and Clinical Risk Management0 citationsOpen Access

Ultrasound Assessment of Preoperative Gastric Contents for Predicting Aspiration Risk in Surgical Patients: A Scoping Review and Future Directions

YLYuzhou LiUniversity of Electronic Science and Technology of China LTLi TangUniversity of Electronic Science and Technology of China SZShihua ZouUniversity of Electronic Science and Technology of China

Key Points

To explore the use of ultrasound in assessing preoperative gastric contents as a predictor of aspiration risk in surgical patients.
Conducted a scoping review of existing literature on ultrasound assessment and aspiration risk.

Structured PICO

Does preoperative ultrasound assessment of gastric contents predict aspiration risk in surgical patients?

Population

Adult surgical patients undergoing preoperative ultrasound assessment of gastric contents across 44 studies, including pregnant women, patients with diabetes, kidney disease, gallbladder disease, gastrointestinal tumors, GLP-1RA users, and emergency or elective surgery patients.

Intervention

Preoperative point-of-care ultrasound assessment of gastric contents (qualitative, quantitative, or combined)

Outcome

Incidence of 'full stomach' (aspiration risk) and changes in anesthetic management strategiessurrogate

Preoperative gastric ultrasound is a valuable tool for assessing gastric contents and identifying aspiration risk, allowing for tailored anesthesia strategies, though standardized thresholds and protocols are still needed.

Abstract

Introduction: This scoping review aims to summarise studies evaluating gastric contents in surgical patients using preoperative ultrasound, discuss current challenges, and propose future directions. Methods: The system retrieved data from 8 databases, including PubMed, with a search period spanning from the inception to May 11, 2025. The scoping review follows the JBI scoping review framework and the PRISMA-ScR reporting guidelines. Results: A total of 44 studies were included. The research involved various perioperative populations and surgical procedures, with a "full stomach" rate ranging from 0% to 57.7%. Ultrasound operators included anesthesiologists, sonographers, and medical consultants. Assessment methods comprised qualitative, quantitative, or combined approaches. Evaluation metrics included gastric contents nature, Perlas 3-point grading system, gastric antral cross-sectional area (CSA), and gastric volume. Conclusion: Preoperative gastric ultrasound can provide information about gastric contents, thereby aiding in the identification of aspiration risk and enabling the adoption of appropriate anaesthesia strategies. However, existing studies still face limitations, including restricted study populations and sample sizes, variations in operator training, a lack of consensus on an evaluation metric threshold value, and diverse gastric volume calculation models. Future studies should expand their scale, enhance training for clinicians in gastric ultrasound, and standardise assessment positions, threshold values, and selection criteria for calculation models. Furthermore, we believe that integrating artificial intelligence with gastric ultrasound can overcome the limitations of manual measurement, offering a direction for precise and convenient preoperative assessment of gastric contents.

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