Indications for ultrasound of the abdominal cavity

Indications for ultrasound examination of the abdominal cavity are an important part of diagnostic measures. One of the reasons for conducting sonography (ultrasound) may be the data obtained during the initial examination of the patient - anamnesis. Characteristic symptoms, complaints of the patient, the specificity of which relates to diseases of the abdominal cavity, can also be the basis for prescribing such an examination. In addition, the results of the doctor's examination, which include palpation, visual examination, percussion, clinical symptoms, the dynamics of laboratory tests, often have a diagnostic "continuation" in the form of ultrasound sonography.

Indications for abdominal ultrasound have many variations, among which the following are standard:

• Nausea, bitterness, epigastric (epigastrium - the area of the upper abdomen) painful subjective (on the part of the patient) sensations;
• Increased flatulence;
• Changes in size, consistency, shape, enlargement of individual parts of all abdominal organs;
• Predictable oncological process;
• Radiating pain, usually to the right side;
• Chronic or periodic constipation, bowel disorder (diarrhea) of unknown etiology;
• Acute pain radiating in both directions - encircling;
• Injuries of various origins in the abdominal cavity;
• Suspected regional enteritis (Crohn's disease);
• Suspected appendicitis (control of abortive appendicitis), including complications after abscess, perforation;
• Fluid accumulating in the abdominal cavity – ascites, bleeding, bile leakage.
• Suspected presence of stones in the kidneys, gall bladder;
• Suspected aortic aneurysm;
• Suspected structural changes in the internal organs of pregnant women;
• Monitoring of therapeutic measures;
• Preventive medical examination.

The sonography technique, and the devices themselves, are constantly being improved, the range of zones and organs studied using ultrasound is gradually expanding, so the indications for abdominal ultrasound also have many options. New unique capabilities of ultrasound today allow us to examine not only such organs that are called parenchymatous (spleen, liver, pancreas), and standard objects of study - the gallbladder and duct system, but also almost everything that is in the peritoneum. The modern sonography technique involves three main stages:

• Primary examination – the most tense areas of the peritoneum (abs) are palpated. The goal is to assess the condition of the subcutaneous fat layer, determine the presence or absence of hernias, gases or fluid in the abdominal cavity;
• Assessment of the condition of the organs indicated in the referral, as well as large vessels (inferior vena cava, aorta);
• A targeted, detailed examination – clarification of possible deviations, pathologies in a particular organ or area.

Indications for abdominal ultrasound are conventionally divided into groups.

Symptoms presented by the patient, subjective complaints:

• Pain in the epigastric region. The goal is to identify the source of painful sensations;
• Dyspepsia, a feeling of discomfort or fullness in the epigastric region after eating, decreased appetite or complete lack of it. The goal is to find possible causes;
• Changes in bowel function – flatulence, diarrhea, changes in stool consistency, constipation;
• Itching, allergy of unclear etiology, change in skin pigmentation. The goal is to identify and confirm the mechanical nature of jaundice;
• Weight loss, fever without clinically clear causes, weakness.

Medical history information:

• Lack of clarity in the clinical picture in the presence of chronic or acute pain, as well as in the case of weight loss;
• Corresponding laboratory test results (leukocytosis, increased ESR);
• Dermatoses, urticaria, persistent rash, including acne;
• Polytrauma, contusion in the epigastric region;
• Postoperative period;
• Oncoprocess;
• Hematological pathology. The goal is to differentiate the etiology and monitor the effectiveness of therapy;
• Combination of diseases, insufficient blood circulation in the systemic circulation;
• Differentiation of various kidney pathologies, as well as monitoring the dynamics of the condition;
• Differentiation of gynecological pathologies, observation and monitoring of therapy effectiveness;
• Infectious diseases.

Indications for abdominal ultrasound may also include the following information from the initial medical examination, including palpation:

• Abnormally pale skin, pigmentation - telangiectasias (spider veins), deformation, Dupuytren's contracture (palmar fibromatosis), hyperemia, vascular network on the anterior surface of the peritoneum, ulcers and fistulas;
• Yellowish discoloration of the mucous membranes (mouth), stomatitis, yellow sclera;
• Asymmetrical abdomen, clearly visible peristalsis;
• Excessively enlarged abdomen. The goal is to differentiate between flatulence, ascites, tumors;
• Palpation reveals enlarged superficial lymph nodes;
• Noises ("sand") in the epigastric region;
• Pain on the part of the patient during percussion or palpation;
• Muscle tension on palpation.

Indications for abdominal ultrasound include data from complex laboratory tests, including the following:

• Unclear etiology of increased ESR, deviations from the normal limits of all formed protein elements of the blood, including leukocytosis;
• Any changes in biochemical studies characteristic of pathologies of the abdominal organs;
• Decreased or increased levels of tumor markers;
• Stool analysis.

Indications for abdominal ultrasound are prospects and opportunities to study hidden factors causing pathology of organs and vessels, provided that the medical institution has the latest equipment, such as ultrasound machines using a contrast agent. Also, indications for abdominal ultrasound are monitoring the biopsy procedure (puncture), decompression therapeutic procedures, drainage, electrochemical lysis and many other important measures for the patient's condition and health.

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