• Bowel sounds
• Gastric cancer
• Intelligent auscultation
• Machine learning
• Prolonged postoperative ileus

• Acute pancreatitis
• Artificial intelligence
• Auscultation
• Bowel sounds
• Enteral nutrition-associated diarrhea

• Humans
• Male
• Female
• Prospective Studies
• Auscultation/methods
• Enteral Nutrition/methods
• Middle Aged
• Artificial Intelligence
• Pancreatitis/diagnosis
• Diarrhea/diagnosis
• Diarrhea/etiology
• Risk Factors
• Aged
• Adult
• Predictive Value of Tests
• ROC Curve

• abdominal ultrasound
• auscultation
• bowel peristalsis
• neonatal bowel sounds
• neonates

• PEG
• artificial intelligence
• bowel sounds
• computer-aided auscultation
• digital health
• gastroenterology
• microwave acoustic sensors
• microwave telemetry
• phonoenterogram

• Infant, Newborn
• Humans
• Artificial Intelligence
• Gastroenterology
• Microwaves
• Neural Networks, Computer
• Inflammatory Bowel Diseases

Surgery is one of the primary treatment modalities for gastrointestinal tumors but can lead to postoperative ileus (POI), which can aggravate pain and increase costs. The incidence of POI can be effectively reduced by monitoring bowel sounds to assist doctors in deciding the timing of transoral feeding. In this study, we prepared a flexible strain sensor based on a graphene composite material and tested the feasibility of sensor monitoring of bowel sounds using simultaneous stethoscope and sensor monitoring. We found that the time of hearing the bowel sounds (12.0–12.1 s) corresponded to the time of waveform change monitored by the sensor (12.036 s), and the sound tone magnitude corresponded to the waveform amplitude. This proves that the application of sensors to monitor bowel sounds is feasible, which opens up a new field for the application of graphene sensors and provides a new way for clinicians to judge the condition of the intestine.

Combining medicine and materials science. First application of graphene strain sensors for monitoring bowel sounds

Disease symptoms often contain features that are not routinely recognized by patients but can be identified through indirect inspection or diagnosis by medical professionals. Telemedicine requires sufficient information for aiding doctors' diagnosis, and it has been primarily achieved by clinical decision support systems (CDSSs) utilizing visual information. However, additional medical diagnostic tools are needed for improving CDSSs. Moreover, since the COVID-19 pandemic, telemedicine has garnered increasing attention, and basic diagnostic tools (e.g., classical examination) have become the most important components of a comprehensive framework. This study proposes a conceptual system, iApp, that can collect and analyze quantified data based on an automatically performed inspection, auscultation, percussion, and palpation. The proposed iApp system consists of an auscultation sensor, camera for inspection, and custom-built hardware for automatic percussion and palpation. Experiments were designed to categorize the eight abdominal divisions of healthy subjects based on the system multi-modal data. A deep multi-modal learning model, yielding a single prediction from multi-modal inputs, was designed for learning distinctive features in eight abdominal divisions. The model's performance was evaluated in terms of the classification accuracy, sensitivity, positive predictive value, and F-measure, using epoch-wise and subject-wise methods. The results demonstrate that the iApp system can successfully categorize abdominal divisions, with the test accuracy of 89.46%. Through an automatic examination of the iApp system, this proof-of-concept study demonstrates a sophisticated classification by extracting distinct features of different abdominal divisions where different organs are located. In the future, we intend to capture the distinct features between normal and abnormal tissues while securing patient data and demonstrate the feasibility of a fully telediagnostic system that can support abnormality diagnosis.

• automated analysis
• bowel sound
• intestine
• motility
• recording

• Artificial Intelligence
• Automation
• Gastrointestinal Diseases/diagnosis
• Humans
• Neural Networks, Computer
• Sound

• Grant for young scientists. Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu
• BIO-TECHMED grant. Politechnika Warszawska
• #POIR.04.04.00-00-5C9B/17-00 Fundacja na rzecz Nauki Polskiej

• bowel sounds
• computer audition
• deep learning
• intestinal obstruction
• machine learning

• bowel sound analysis
• gastric cancer
• intestinal peristalsis
• surgical stress

• Abdomen/physiology
• Adult
• Aged
• Aged, 80 and over
• Auscultation/methods
• Breast Neoplasms/pathology
• Breast Neoplasms/surgery
• Gastrointestinal Motility
• Humans
• Middle Aged
• Operative Time
• Perioperative Care
• Postoperative Period
• Prospective Studies

• abdominal distension
• critical illness
• digestive symptoms
• enteral nutrition
• gastrointestinal motility
• gastrointestinal tract

• Abdominal palpation
• Auscultation
• Bowel sounds
• Medical students
• Semiology

• Abdominal examination
• bowel sounds
• physical examination order

• Borborygmi
• Bowel sound
• Diagnostics
• Gastrointestinal medicine
• Non-invasive tests
• Research quality assessment methodology post-operative ileus
• Systematic review

• Abdomen
• Clinical practice
• Physical examination

• Abdomen
• Auscultation
• Gastrointestinal Diseases/diagnosis
• Humans

• Acute abdomen
• Analgesia
• Diagnosis
• Differential diagnosis
• Guidelines
• Two-step method

• Acute abdomen
• Analgesia
• Diagnosis
• Differential diagnosis
• Guidelines
• Two-step method

AIM: To investigate the accuracy and inter-observer variation of bowel sound assessment in patients with clinically suspected bowel obstruction.

METHODS: Bowel sounds were recorded in patients with suspected bowel obstruction using a Littmann^® Electronic Stethoscope. The recordings were processed to yield 25-s sound sequences in random order on PCs. Observers, recruited from doctors within the department, classified the sound sequences as either normal or pathological. The reference tests for bowel obstruction were intraoperative and endoscopic findings and clinical follow up. Sensitivity and specificity were calculated for each observer and compared between junior and senior doctors. Interobserver variation was measured using the Kappa statistic.

RESULTS: Bowel sound sequences from 98 patients were assessed by 53 (33 junior and 20 senior) doctors. Laparotomy was performed in 47 patients, 35 of whom had bowel obstruction. Two patients underwent colorectal stenting due to large bowel obstruction. The median sensitivity and specificity was 0.42 (range: 0.19-0.64) and 0.78 (range: 0.35-0.98), respectively. There was no significant difference in accuracy between junior and senior doctors. The median frequency with which doctors classified bowel sounds as abnormal did not differ significantly between patients with and without bowel obstruction (26% vs 23%, P = 0.08). The 53 doctors made up 1378 unique pairs and the median Kappa value was 0.29 (range: -0.15-0.66).

CONCLUSION: Accuracy and inter-observer agreement was generally low. Clinical decisions in patients with possible bowel obstruction should not be based on auscultatory assessment of bowel sounds.

• Bowel obstruction
• Auscultation
• Bowel sounds
• Diagnostic test
• Accuracy
• Observer variation
• Multi-observer
• Prospective

• Acoustics
• Auditory Perception
• Auscultation/instrumentation
• Auscultation/methods
• Humans
• Intestinal Obstruction/diagnosis
• Intestinal Obstruction/surgery
• Observer Variation
• Predictive Value of Tests
• Prognosis
• Prospective Studies
• Reproducibility of Results
• Signal Processing, Computer-Assisted
• Sound Spectrography
• Stethoscopes

AIM: To determine the value of bowel sounds analysis using an electronic stethoscope to support a clinical diagnosis of intestinal obstruction.

METHODS: Subjects were patients who presented with a diagnosis of possible intestinal obstruction based on symptoms, signs, and radiological findings. A 3M™ Littmann^® Model 4100 electronic stethoscope was used in this study. With the patients lying supine, six 8-second recordings of bowel sounds were taken from each patient from the lower abdomen. The recordings were analysed for sound duration, sound-to-sound interval, dominant frequency, and peak frequency. Clinical and radiological data were reviewed and the patients were classified as having either acute, subacute, or no bowel obstruction. Comparison of bowel sound characteristics was made between these subgroups of patients. In the presence of an obstruction, the site of obstruction was identified and bowel calibre was also measured to correlate with bowel sounds.

RESULTS: A total of 71 patients were studied during the period July 2009 to January 2011. Forty patients had acute bowel obstruction (27 small bowel obstruction and 13 large bowel obstruction), 11 had subacute bowel obstruction (eight in the small bowel and three in large bowel) and 20 had no bowel obstruction (diagnoses of other conditions were made). Twenty-five patients received surgical intervention (35.2%) during the same admission for acute abdominal conditions. A total of 426 recordings were made and 420 recordings were used for analysis. There was no significant difference in sound-to-sound interval, dominant frequency, and peak frequency among patients with acute bowel obstruction, subacute bowel obstruction, and no bowel obstruction. In acute large bowel obstruction, the sound duration was significantly longer (median 0.81 s vs 0.55 s, P = 0.021) and the dominant frequency was significantly higher (median 440 Hz vs 288 Hz, P = 0.003) when compared to acute small bowel obstruction. No significant difference was seen between acute large bowel obstruction and large bowel pseudo-obstruction. For patients with small bowel obstruction, the sound-to-sound interval was significantly longer in those who subsequently underwent surgery compared with those treated non-operatively (median 1.29 s vs 0.63 s, P < 0.001). There was no correlation between bowel calibre and bowel sound characteristics in both acute small bowel obstruction and acute large bowel obstruction.

CONCLUSION: Auscultation of bowel sounds is non-specific for diagnosing bowel obstruction. Differences in sound characteristics between large bowel and small bowel obstruction may help determine the likely site of obstruction.

• Bowel sounds
• Intestinal obstruction
• Spectral analysis
• Electronic stethoscope