Ultrasound examination (ultrasound) of the abdominal organs

The history of the introduction of the method of ultrasound diagnostics of internal tissues, organs and cavities into clinical practice goes back over eighty years, although ultrasound was first discovered at the end of the 18th century. Since that time, about a century and a half has passed, until finally the achievements of science and progress made it possible to use it first for the purposes of physiotherapy, and since 1949 – for the diagnosis of pathology in patients. Ultrasound examination of internal organs everywhere began to be carried out in medical institutions in the 60s of the last century, and today ultrasound of the abdominal organs is considered one of the most informative and safe ways to examine a patient’s condition.

Diagnosis of the Abdominal Cavity with Ultrasound: Mechanism and Procedure

Ultrasound technology uses high-frequency ultrasound waves to form an image of the internal organs on the monitor of an ultrasound machine. These waves have a frequency response of over 20000 cycles per second. The basis of the ultrasound method is the property of ultrasonic waves to be reflected, absorbed or pass through tissues of various densities.

The creation of the first ultrasound machines for diagnostics would have been impossible without the discovery at the end of the 19th century of the direct and inverse piezoelectric effect, which reflects the ability of single crystals of certain substances to absorb and produce electrical charges under the influence of external factors.

The working part of the ultrasound machine contains a source and receiver of ultrasonic waves. The source generates ultrasonic waves of a certain frequency, which are reflected, transmitted or absorbed by human organs and tissues. An ultrasound receiver registers the distortion or reflection of waves, and a special computer program transforms them into an image of a section of an organ or tissue.

Ultrasound diagnostic devices of the first generations could only show a two-dimensional image, however, the process of improving computer and diagnostic equipment made it possible to obtain a three-dimensional ultrasound image, conduct a study using the tissue or double harmonic method with increased image quality and contrast, perform sonoelastography (studies using pressure that causes a characteristic tissue contraction). Ultrasound technology with the ability to navigate inside the vessels and ducts allows you to display a four-dimensional image on the screen of the device.

The ultrasound procedure is prescribed for a thorough medical examination of the abdominal organs. Based on the results of the study, the doctor can analyze the condition of the organs, size and shape, structure and location in relation to each other. By comparing the information with normal indicators, a specialist can determine deviations from the normal state, as well as the presence of pathological processes in the early stages of their manifestation. All these data are used to develop a treatment regimen and monitor the effectiveness of the treatment. In addition, the procedure is also used for preventive purposes, for example, as part of a general medical examination.

What organs are visible on abdominal ultrasound?

The abdominal cavity is limited from above by the diaphragm, the muscular corset of the back and the column of the spine are located dorsally, in front – the abdominal muscles, from below – the pelvic bones and muscles. The inner shell of the abdominal cavity is represented by the peritoneum with many nerve endings. According to its structure, it consists of visceral and parietal sheets, which pass into each other. The visceral peritoneum covers the gallbladder, liver, spleen, pancreas, and partially the stomach.

Based on the image obtained with the help of abdominal ultrasound, it is possible to obtain information about:

• liver;
• spleen;
• kidneys;
• pancreas;
• gallbladder;
• bile ducts;
• blood and lymph vessels.

Despite the fact that the kidneys anatomically belong to the retroperitoneal space, as a rule, they are examined with the organs of the abdominal cavity.

Regarding the stomach and intestines, their diagnosis by ultrasound is, in most cases, impractical. The fact is that ultrasonic waves cannot sufficiently visualize hollow organs. However, in some cases, instead of performing fibrogastroduodenoscopy or colonoscopy, the doctor may examine the stomach and intestines using an ultrasound probe.

Indications for ultrasound diagnostics of the abdominal cavity

Symptoms that cause the patient to be referred for an ultrasound examination of the abdominal cavity include various abnormal manifestations, pain and atypical reactions.

Referral to the procedure is recommended in such cases:

• if there is a feeling of heaviness after eating, localized in the right side or right iliac region;
• in violation of appetite, along with unpleasant belching and nausea, the appearance of bad breath;
• with periodic pain in the lumbar region, difficult urination, an unreasonable increase in body temperature;
• with diagnosed hepatitis, pain in the right hypochondrium, bitterness in the mouth with nausea;
• if there are signs of hormonal disorders;
• with disorders of the digestive process, girdle pain in the abdomen, lack of appetite and symptoms characteristic of the state of intoxication of the body;
• with diagnosed diabetes;
• when detecting changes in organs during palpation;
• in the presence of malaria, sepsis, mononucleosis, jaundice;
• with suspicion of stones and sand in the kidneys, gallbladder and bile ducts.

In what cases is it contraindicated to prescribe the procedure

There are such patient conditions when ultrasound becomes impractical or impossible, even despite the complete safety of the method itself.

Contraindications to the study are:

• pustular rashes located in the examined area;
• acute infectious diseases;
• acute pathologies of blood circulation in the brain;
• heat;
• the presence of a significant area of ​​the wound surface on the abdomen, as well as a violation of the integrity of the skin.

As for age restrictions, the procedure does not have them. Ultrasound examination of the abdominal organs is prescribed for children of any age, even infants.

Pregnancy is not an absolute contraindication for the appointment of abdominal ultrasound. This method during pregnancy is prescribed much more often than, for example, computed tomography or radiography. In some cases, this diagnostic method is also prescribed to study the state of fetal development.

Ultrasound of the abdominal organs is not prescribed immediately after colonoscopy and gastroscopy, as these procedures spasm smooth muscles and distort the results. After fluoroscopy with a barium contrast agent, the results of ultrasound are also questionable due to the fact that the contrast accumulated in the folds of mucus is visualized during the study, therefore, immediately after fluoroscopy with contrast, ultrasound is not performed.

Special requirements for preparation for the study

Ultrasound examination of the abdominal organs can provide accurate and informative results only on the condition that the subject begins to fulfill in advance all the requirements that the doctor prescribes for patient preparation. Otherwise, during the diagnosis, interference may occur in the image, distorting the ultrasound picture.

The doctor may verbally list all the preparatory requirements to the subject, and in some medical institutions these lists are given to patients in printed form for convenience.

The procedure can only be carried out on an empty stomach. If it is scheduled for the first half of the day, the patient should refuse breakfast. If the ultrasound is performed after 15 pm, no later than 9 am, you can afford a light breakfast. An hour and a half before the start, it is not recommended to drink any liquid. Also, an hour or two before the ultrasound, you can not chew gum and smoke – these actions provoke spasm of smooth muscles.

People with a tendency to constipation should take a laxative the night before the procedure as part of their preparation.

All medications taken at this time must be reported to the diagnostician in advance. On ultrasound, the patient takes with him the results of all previous tests and examinations.

For those who have a tendency to increased formation of gases in the digestive tract, a special slag-free diet with a reduced content of coarse dietary fiber is recommended. They begin to adhere to it 2-3 days before the date of the examination.

In addition to dietary restrictions, taking sorbents, such as activated charcoal, after each meal helps reduce gas production.

A slag-free diet, as part of the preparation for the procedure, implies the rejection of such products:

• milk and dairy products;
• fresh bread, especially black;
• fresh fruits and vegetables;
• fatty and fried foods;
• smoked meats, spicy and pickled foods;
• baking and muffins;
• alcoholic and carbonated drinks, strong tea and coffee;
• beans.

The diet before the study consists of lean meat, poultry and fish, cereals, yeast-free stale white bread, baked or boiled vegetables, vegetable broths, non-concentrated clear juices, compotes. Be sure to drink at least one and a half liters of pure water per day.

All these rules are not relevant in cases where an urgent diagnosis is necessary, when it is not possible to wait 2-3 days, for example, in acute appendicitis.

Research technique

Before starting the ultrasound procedure, the subject removes metal jewelry from himself. He is placed on the couch in the supine position. In the process, the doctor will ask the patient to change position, turning over to the left or right side.

The study is carried out abdominally, that is, through the front wall of the abdomen. A special conductive gel is applied to the abdomen, which improves the glide of the sensor over the body and helps to reduce noise in the image.

The procedure is completely painless and takes no more than 20-30 minutes.

The algorithm for the implementation of the inspection involves an ultrasound of larger organs in the first place. For example, the examination may begin with the liver, the size of the liver, its location and shape, structural features and ability to transmit ultrasound waves, as well as the condition of the vessels, are evaluated and recorded.

Next, the doctor proceeds to the study of the gallbladder and bile ducts:

• their forms;
• structures and conditions of the walls;
• the presence or absence of foreign inclusions;
• bile condition.

The diagnostician checks the position of the pancreatic duct, the lumen of the bile ducts, the portal, inferior and splenic veins. Further, he evaluates the condition of the spleen, pancreas and kidneys in a similar way. The study of the pancreas is often difficult due to the peculiarities of its anatomical location – it is partially overlapped by the intestines and stomach.

To visualize the spleen, the patient is placed on the right side, since access to it is also partially obstructed by the ribs and lungs.

In some cases, during an ultrasound of the abdominal cavity, an examination of the bladder is also performed.

Features of preparation and diagnostics for children

Preparing a child, as well as an adult, includes dietary restrictions. For 2-3 days, it is necessary to exclude from the menu products that provoke increased gas formation, as well as sweets and sweets. If a small patient has a tendency to flatulence, he is prescribed enzyme and absorbent preparations.

For children of any age, ultrasound is performed on an empty stomach. Mothers of infants need to calculate that the last feeding before the procedure is carried out no later than 3 hours. It is undesirable to give the child fruit or vegetable purees before the study, as they are digested for a long time.

The process of conducting an ultrasound examination of the abdominal organs in children is no different from a similar procedure in adults. Diagnosis is carried out by a special ultrasound probe using a conductive gel.

What does an abdominal ultrasound show?

What is the purpose of this examination method, and what can it show? Patients often ask this question to doctors when they refer them for a procedure.

During the ultrasound, studying the liver, the doctor-diagnostician can determine hepatosis of the liver, calcifications and cysts in the liver, the presence of chronic hepatitis, tumor neoplasms of any nature, injuries and hematomas, metastases, abscess and increased pressure in the portal vein of the liver.

In the gallbladder, ultrasound can detect the development of cholecystitis, determine the patency of the ducts, as well as the presence of stones and polyps.

Visualization of the pancreas is a little difficult due to the fact that it covers the intestines and stomach. However, by how homogeneous the echogenicity of the organ is, the doctor detects the presence of pancreatitis, pancreatic necrosis or nodes in the organ on the image, even in the early stages of appearance.

When visualizing the spleen, enlargement of the organ or its displacement may indicate the presence of abscesses, hematomas, leukemic infiltration, ruptures, or infarcts.

Ultrasound of the stomach or intestines is not very informative for displaying the internal structures of hollow organs, however, their size and location can be indicated from its picture. Also, the results of ultrasound can visualize the presence of a cyst, gastroesophageal reflux or gastric hernia, cysts and neoplasms in the intestine, the presence of fluid in the abdominal cavity.

Inspection of the kidneys determines the presence and location of stones, foci of inflammation, tumors.

Also, the results of the examination show an increase in the lymph nodes in the abdominal cavity.

Interpretation of diagnostic results

The interpretation of the results of an ultrasound of the abdominal cavity is carried out by a doctor of appropriate qualification – an ultrasound diagnostician. All data obtained during the ultrasound examination, the doctor reflects in the conclusion. It usually takes no more than 20-30 minutes to complete.

As a result, the patient receives an ultrasound report in his hands, as well as pictures of the ultrasound image recorded by the device and printed on special paper, which he passes to his attending physician who issued the referral for the examination.

If any data on the state of the internal organs after the ultrasound scan causes distrust or suspicion of the presence of serious pathologies, the ultrasound diagnostician may recommend undergoing more specialized diagnostic procedures.

Ultrasound examination of the abdominal organs is very often prescribed by doctors in the presence of characteristic symptoms of damage to these organs. The method is considered completely harmless, it has a small list of contraindications. Ultrasound can be done even for young children and pregnant women.

The procedure is highly informative, especially if the patient was conscientious about following the rules of preparation – he followed a diet, did not smoke, took a sufficient amount of liquid and came to the diagnostic session on an empty stomach. Ultrasound results can show a variety of pathologies – manifestations of oncological diseases, inflammatory processes, developmental pathologies, polyps, sand and stones, abscesses, hematomas, and other disorders in the abdominal organs.

Sources of