Point-of-care ultrasound (PoCUS) in the rapid diagnosis of biliary ileus: A case report

Biliary ileus is a rare yet potentially life-threatening cause of mechanical intestinal obstruction, predominantly affecting elderly, comorbid patients. Often underdiagnosed due to non-specific symptoms, it can now be detected earlier with point-of-care ultrasound (PoCUS). We present the case of an 85-year-old male with non-specific abdominal symptoms where PoCUS at the bedside facilitated early identification of a distal ileal stone, significantly expediting radiological confirmation and surgical management. This case underscores the value of PoCUS in early diagnostic pathways, especially in frail or elderly patients, where rapid decision-making is critical. Early use of PoCUS in patients with non-specific abdominal symptoms can facilitate timely diagnosis of biliary ileus and expedite appropriate management, ultimately improving patient outcomes. • Point-of-care ultrasound enabled early diagnosis of gallstone ileus. • Biliary ileus was identified before CT through bedside ultrasound. • Prompt diagnosis led to timely surgical intervention and recovery. • Case highlights PoCUS utility in elderly with vague abdominal pain. • Ultrasound should be integrated early in obstruction assessment.