Method of ultrasound of the pancreas
Last reviewed: 23.04.2024
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There may be difficulties in visualizing the pancreas, especially the tail.
Begin with transverse sections in the upper abdomen, moving the sensor from one side to the other, from the edge of the costal arch to the navel. Then make longitudinal sections, moving the sensor down and up the upper abdomen. If it is necessary to examine a particular area, ask the patient to take a deep breath and hold his breath on inhalation.
Gas
If gas in the intestine interferes with the image:
- Use light sensor pressure or cuts in the recumbent position on the side, on the right and left.
- If necessary, give the patient 3 or 4 glasses of water, wait a few minutes for air bubbles to dissipate, then repeat the study in the patient's sitting or standing position, visualizing the pancreas through a liquid-filled stomach.
- If the patient can not stand, place it on the left or right side and let it drink through the straw, then scan in the patient's position on the back.
Lateral scanning
Begin a transverse scan through the abdomen, moving the sensor down to the patient's legs until the splenic vein is visualized as a linear tubular structure with a thickened medial end. At this point, it merges with the superior mesenteric vein at the level of the body of the pancreas. The superior mesenteric artery will be visualized in the transverse section just below the vein. By tilting and turning the sensor, you can visualize the head and tail of the pancreas.
Continue laterally scanning down to obtain the image of the head of the pancreas and the hook-shaped process (if any) between the lower hollow and portal vein.
Longitudinal scanning
Start longitudinal scanning immediately to the right of the middle line, find the tubular structure of the inferior vena cava with the head of the pancreas in front, below the liver. The lower vena cava should not be squeezed or pushed back by the normal pancreas.
Continue longitudinal scanning, moving to the left. Find the aorta and the superior mesenteric artery. This will help to identify the body of the pancreas.
Scan in the supine position
After a longitudinal and transverse scan, rotate the patient to the right side and scan the pancreas through the spleen and left kidney. This will help to detect the tail of the pancreas.
Then, in the patient's position on the left side, ask him or her to take a deep breath and hold his breath, scan the pancreas through the liver. This reveals the head of the pancreas.
Scanning in the standing position
When visualization is difficult due to intestinal gas, give the patient 3 or 4 glasses of water. After the patient has finished drinking water, wait a few minutes for the air bubbles to dissipate, then in the patient's sitting or standing position, visualize the pancreas through the stomach. This technique is especially useful for visualizing the tail of the pancreas.
The visualization of the entire pancreas is always complex. It is necessary to use different projections and the inclination angles of the sensor.
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