Indications for ultrasound of the gastrointestinal tract

Indications for ultrasound of the gastrointestinal tract are all pathological changes in the function of the gastrointestinal tract. Ultrasound examination is not the main and standard in the GI examination because the echogenicity of the stomach is often low. This is due to the anatomical localization of the organ itself, as well as to the constant processes occurring in the gastrointestinal tract. However, ultrasound can provide information on the functioning and condition of the outlet of the gastrointestinal tract. However, ultrasound can provide information on the functioning and condition of the outlet of the gastrointestinal tract. Well visualized: the curvature of the stomach - large and small, canal and cave of the gatekeeper, the zone of passage into the duodenum (pars pylorica), the beginning of the duodenum (ampulla duodeni). All other parts, the GI tract, the echogram examines with not very high accuracy, therefore they require other methods of investigation. Nevertheless, ultrasound is an important component of general diagnostic measures, since the main pathologies of the stomach are localized to the exit zone. Advantages of the ultrasound method over other, classical - X-ray, endoscopic ones is that the X-ray reveals only one projection, and endoscopy can be dangerous in terms of possible additional infection, in addition it does not provide information in cases of infiltrative oncology. Echography provides an opportunity to study the state of the gastrointestinal tract in many projections and planes. Ultrasound also allows a detailed study of the painful area, which reduces the time of the diagnostic period. Echography is highly informative in the study of peristalsis and DGR (duodenal-gastral reflux) with the help of duplex research.

Despite the echogenic specificity of the stomach and, in principle, the entire gastrointestinal tract, ultrasound can cope well with the detection of functional disorders and inflammations. Often an indication for echography of the gastrointestinal tract is a clinically pronounced erosive process. Timely clarifying diagnostics helps to minimize the risk of ulcerative, oncological processes and prescribe effective treatment.

Indications for ultrasound of the gastrointestinal tract can be combined into the concept of abdominal pains, which occur in pancreatitis, cholelithiasis (cholelithiasis), food poisoning, gastroenteritis or gastritis, adnexitis, intestinal obstruction and many other conditions. Echography of the gastrointestinal tract is also prescribed and if there is a deviation in the analysis of liver samples. Ultrasound of the gastrointestinal tract often accompanies other research and treatment activities, such as endoscopy, aspiration, biopsy.

Indications for ultrasound of the gastrointestinal tract include all destructive processes and possible oncological diseases in the gastrointestinal tract. These include: 

• Inflammatory processes of the pancreas, which have a direct relationship with the functioning of the gastrointestinal tract; 
• All kinds of inflammatory diseases in the area of the duodenum and pars pylorica (pyloric part of the stomach) - gastroduodenitis; 
• All kinds of inflammatory processes of the gastric mucosa - gastritis; 
• GERD (gastroesophageal reflux disease); 
• PGH - portal-hypertensive gastropathy; 
• Achalasia of the esophagus (cardia); 
• LCB - cholelithiasis; 
• All inflammatory processes of the intestine of any etiology.

Ultrasound is done in several ways. The fasting procedure is mandatory. The first stage of the study involves scanning with the help of contrast, which is purified water. The patient drinks at least half a liter of liquid with slow sips, trying not to swallow the air. Thus, a quantitative indicator of the stomach contents, which should not exceed 40 milliliters, is examined. Also at this stage, the cross-sectional diameter and the wall thickness are estimated, which should normally be 2.5 to 5 millimeters. All deviations from normal borders are considered a syndrome of a hollow stomach. It can be a thickening of the walls of the stomach, hyperechoic content, violation of the wall layers, changes in the contours of the stomach. The received indices can signal about erosive pathologies of the gastric mucosa, the presence of polyps, gastritis, oncoprocess. Also, using the contrast in the form of water, the evacuation properties of the stomach are evaluated. If the pyloric department is deformed, which happens with ulcers or oncology, the evacuation is noticeably lower in speed. Also, a decrease in the rate of evacuation can be a sign of endocrine pathologies and a general anatomical omission of organs. DGD (duodenogastric reflux) is detected using standard echography and a duplex mode.

Indications for ultrasound of the gastrointestinal tract depend on the anatomical features of the gastrointestinal tract, which can provide echographic information or are not subject to scanning at all. The ultrasonic method is suitable for studying: 

• The whole stomach, including the walls and their structures. Echography can determine the ply of the walls (normal-4), including the fifth layer - serosa; 
• Conditions of the esophagus in two departments - cervical and cardiac divisions; 
• The terminal zone of the small intestine; 
• The folds of the large intestine, its condition from the coecum (cecum) to the rectum (rectum).

Indications for ultrasound of the gastrointestinal tract are determined by the attending physician on the basis of the collected history, clinical picture and symptoms, laboratory tests and other information that indicate the need for echography of the gastrointestinal tract.

[1], [2], [3], [4], [5], [6]