Technique of ultrasound of the abdominal cavity
Last reviewed: 19.10.2021
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Position of the patient. The patient can lie in a comfortable position on the back. Under the head, you can put a small pillow, in the case of a pronounced strain of the anterior abdominal wall, the pad can also be placed under the patient's knees.
Spread the belly with gel.
The patient is allowed to breathe quietly, however, in the study of individual organs, breath holding is required on inspiration.
Select the sensor. Use a 3.5 MHz sensor for adults and a 5 MHz sensor for children and thin adults. Convex or sector sensors are preferred.
Set the correct level of overall sensitivity. Start the research by placing the sensor centrally in the upper abdomen under the xiphoid process and ask the patient to take a deep breath and hold his breath on inhalation.
Turn the sensor to the right before the liver begins to visualize. Adjust the sensitivity so that the image has a normal homogeneous structure. A highly echogenic line of the diaphragm should be clearly visible right behind the posterior parts of the liver.
The portal and hepatic veins should be visualized as tubular structures with an anisotropic lumen. The walls of the portal vein are highly vascular, but the walls of the hepatic veins are almost invisible.
After you have adjusted the sensitivity of the device, slowly move the sensor from the center line to the right, stopping every inch and checking the image. Check on different levels. After you have explored the right side, explore the left side in the same way. In this case, the sensor needs to be directed in different directions in order to better localize the object and get more information. It is very important to examine the entire abdominal cavity: if after changing the angle of inclination of the sensor the upper part of the liver or spleen is not visualized, it is necessary to scan through the intercostal spaces.
After these transverse scans, rotate the sensor 90 degrees and start scanning again from the xiphoid process. Once again, localize the liver and, if necessary, ask the patient to hold his breath at a deep breath to visualize it better. Make sure that the sensitivity level is set correctly. If necessary, tilt the sensor towards the patient's head. Carry out a study of intercostal spaces.
Below the ribs, hold the sensor in a vertical position and move it towards the legs (caudal). Repeat in different vertical planes throughout the abdomen.
If any part of the abdomen is visualized poorly, you can conduct a study in the patient's position sitting or standing. If necessary, a study is performed in the patient's position on the side with a raised head; more often it is used in the study of the kidneys and spleen. Do not hesitate to turn the patient.
It is important to visualize:
- Aorta and lower vena cava.
- Liver, portal vein, hepatic veins.
- Biliary tract and gallbladder.
- The spleen.
- The pancreas.
- The kidneys.
- Diaphragm.
- Bladder (if it is full).
- Organs of the small pelvis.