Indications for ultrasound of the abdominal cavity

Indications for ultrasound of the abdominal cavity are an important part of diagnostic activities. One of the reasons for sonography (ultrasound) can 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 the appointment of such a survey. In addition, the results of a 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 ultrasound of the abdominal cavity have many options, among which the following are standard: 

• Nausea, bitterness, epigastric (epigastrium - the area of the upper abdomen) painful subjective (from the patient's side) sensation; 
• Increased flatulence; 
• Change in size, consistency, shape, increase in individual parts of all organs of the abdominal cavity; 
• Predicted oncological process; 
• Irradiating pain, as a rule, on the right side; 
• Chronic or periodical constipation, stool disorder (diarrhea) of unclear etiology; 
• Sharp pain, irradiating in both directions - girdling; 
• Injuries of various origin in the abdominal cavity; 
• Suspicions of regional enteritis (Crohn's disease); 
• Alleged appendicitis (control of abortive appendicitis), including complications after abscess, perforation; 
• The liquid accumulated in the abdominal cavity - ascites, bleeding, the bile flowed. 
• Suspicions for the presence of concrements in the kidneys, gall bladder; 
• Suspicion of an aneurysm of the aorta; 
• Suspicion of structural changes in internal organs in pregnant women; 
• Monitoring of therapeutic measures; 
• Dispensary preventive examination.

The method of sonography, and the devices themselves, is constantly improving, the circle of zones and organs studied by ultrasound is gradually expanding, so the indications for ultrasound of the abdominal cavity also have a variety of options. New unique possibilities of ultrasound today allow us to investigate not only such organs that are called parenchymatous (spleen, liver, pancreas), and standard objects of investigation - the gall bladder and duct system, but virtually everything that is in the peritoneum. Modern methodology of sonography involves three main stages: 

• Primary examination - the most strained areas of the peritoneum (the press) are palpated. The aim is to assess the condition of the subcutaneous fat layer, to determine the presence or absence of hernias, gases or liquids in the abdominal cavity; 
• Assessment of the condition of organs that are indicated in the direction, as well as large vessels (inferior vena cava, aorta); 
• Aimed, detailed examination - clarification of possible deviations, pathologies in a separate organ, zone.

Indications for ultrasound of the abdominal cavity are conventionally divided into groups.

Symptoms presented by the patient, subjective complaints: 

• Pain in the epigastric region. The goal is to reveal the source of painful sensations; 
• Dyspepsia, feelings of discomfort or overcrowding in the epigastric zone after eating, a decrease in appetite or a complete lack of it. The goal is to find possible causes; 
• Changes in the functioning of the intestine - flatulence, diarrhea, a change in the consistency of faeces, constipation; 
• Itching, an allergy of unclear etiology, a change in the pigmentation of the skin. The goal is to identify and confirm the mechanical nature of jaundice; 
• Weight loss, fever in the absence of clinically clear causes, weakness.

Information on the anamnesis: 

• Lack of clarity in the clinical picture in the presence of chronic or acute pain, as well as with a decrease in body weight; 
• Corresponding indicators of laboratory tests (leukocytosis, increase of ESR); 
• Dermatoses, hives, persistent rashes, including acne; 
• Polytrauma, bruise in the epigastric region; 
• Postoperative period; 
• Oncoprocess; 
• Hematological pathology. The goal is to differentiate etiology and monitor the effectiveness of therapy; 
• The combination of diseases, insufficient circulatory circulation of a large circle; 
• Differentiation of various pathologies of the kidneys, as well as monitoring of the dynamics of the condition; 
• Differentiation of gynecological pathologies, observation and monitoring of the effectiveness of therapy; 
• Infectious diseases.

Indications for ultrasound of the abdominal cavity may also suggest the following information of primary medical examination, including palpation: 

• Abnormally pale skin, pigmentation - telangiectasia (vascular asterisks), deformity, Dupuytren's contracture (palmar fibromatosis), hyperemia, vascular mesh on the anterior surface of the peritoneum, ulcers and fistulas; 
• Jaundice color of the mucous membranes (mouth), stomatitis, yellow sclera; 
• Asymmetric abdomen, clearly peristalsis; 
• Excessively enlarged abdomen. The goal is to differentiate flatulence, ascites, tumors; 
• Palpation reveals enlarged superficial lymph nodes; 
• Noises ("sand") in the epigastric region; 
• Pain from the patient with percussion or palpation; 
• Tension of muscles during palpation.

Indications for ultrasound of the abdominal cavity are also data from complex laboratory tests, including the following: 

• Unclear etiology of ESR increase, deviations from the boundaries of the norms of all the formed protein elements of blood, including leukocytosis; 
• Any changes in biochemical studies, characteristic of pathologies of the abdominal cavity; 
• Reduced or elevated levels of oncomarkers; 
• Anal feces.

Indications for ultrasound of the abdominal cavity are prospects and opportunities to investigate the hidden factors that cause the pathology of organs and vessels, provided that the medical institution has the latest equipment, such as ultrasound apparatus using contrast medium. Also, the indications for ultrasound of the abdominal cavity are the control of the biopsy procedure (puncture), decompression therapeutic procedures, the introduction of drainage, electrochemical lysis and many other things important for the condition and health of the patient of the event.

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