Ultrasound diagnostics ofbowel diseases in adults

Abstract

Ultrasonography is the first step in the diagnosis of acute and chronic diseases of the abdominal cavity by imaging methods. In an increasing number of cases ultrasound examination is used to diagnose lesions located in the intestines, which beside the mesenteries and the omentum are an important part of the abdomen. The aim of this overview paper is to present the current possibilities of ultrasonography in the assessment of pathologies of the gastrointestinal tract. Currently it is possible to present the anatomy of the intestinal wall, vascular network and the surrounding tissue with a great precision, even through transabdominal access. It is facilitated by digital sonograms, especially using harmonic imaging, spatial and XRES imaging as well as variable transducer pressure. Even better results can be obtained using endoscopic ultrasound, which can be equipped with a Doppler blood flow imaging facility and elastography. In addition, endoscopic ultrasound can be used to guide the collection of material for cytology or pathomorphology examination and the performance of various medical procedures. Over the recent years the diagnostic value of ultrasound increased following the introduction of intestinal hydrosonography and ultrasound contrast media, which also work very well in fistulography. Therefore, it is not surprising that ultrasonography used by an experienced practitioner makes it possible to diagnose the vast majority of intestinal pathologies and their complications as well as the results of the treatment applied. This is especially applicable to infectious, inflammatory, ischaemic and various neoplastic diseases. In the case of neoplastic lesions the stage of local advancement of the process can be determined, especially using endosonography. In a transabdominal examination this method achieves high efficacy in the diagnosis of acute appendicitis and in diverticulitis of the large intestine, which is decisive for the selection of the method of treatment. Its value was also demonstrated in bowel obstruction and in less frequently occurring lesions such as epiploic appendagitis or greater omental infarction. Ultrasonography has little importance in the diagnosis of gastrointestinal tract bleeding in patients with a substantial amount of gas in the digestive tract, obese patients and uncooperative ones.

Keywords

• small intestine
• large intestine
• ultrasonography
• examination methodology
• disease lesions