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Ultrasound signs of a normal gastrointestinal tract
Last reviewed: 04.07.2025

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Ultrasound examination can identify various anatomical sections of the gastrointestinal tract.
Esophagus
The abdominal part of the esophagus can be visualized in a longitudinal section below the diaphragm and in front of the aorta. In transverse sections, the esophagus is located behind the left lobe of the liver.
Stomach
In the absence of filling, the fundus of the stomach is easily identified as a star-shaped structure. The body of the stomach is visualized on cross-sections immediately anterior to the pancreas. If in doubt, give the patient 1 or 2 glasses of water to distend the stomach cavity.
Large and small intestines
The echographic picture of the intestine changes significantly depending on the degree of its filling, the amount of liquid, fecal matter and gas. Normal peristalsis can be determined by ultrasound examination. If the intestine is filled with liquid, then characteristic moving echostructures will be determined in it. Peristalsis is usually determined in the small intestine, occasionally in the large intestine.
During echography, the intestinal wall is defined as a two-layer structure, with an outer hypoechoic layer (muscle tissue) and an inner hyperechoic layer (mucous membrane in contact with gas in the intestine). The muscular layer, depending on which section of the intestine is visualized and to what extent it is filled, rarely exceeds 3 mm in thickness.
Gas in the intestine is represented by hyperechoic structures and can produce reverberation artifacts and posterior acoustic shadowing, while fluid in the intestine is anechoic or has a certain internal structure as a result of the presence of fecal matter.
Normal movements of fluid in the intestine due to respiration must be distinguished from peristaltic movements.