Contents
Ultrasound diagnostics is a universal diagnostic method that is used in various fields of medicine. Until recently, it was rather difficult to examine the intestines, and ultrasound was practically not used in proctology. This is explained by the fact that the intestinal lumen contains gas, which distorts the image. The development of ultrasound technologies has made it possible to overcome this drawback, and now ultrasound examination of the intestine is considered one of the most popular measures in the examination and diagnosis. This method plays a special role in the detection of oncological processes.
Types of ultrasound examination of the intestine
For visualization of the intestine, 2 ultrasound methods are used: transabdominal and rectal. The transabdominal method involves an ultrasound examination through the abdominal cavity. This method is used without filling the intestines, while contrast is introduced, and the bladder must be filled.
The rectal method uses a rectal probe. You can also do an intracavitary examination using a vaginal probe. This method is optional and only possible for women.
In order to cover the intestines as much as possible, 2 methods are most often used at once. Transabdominal ultrasound does not always give a 100% result, since in 15% of cases the bladder is not filled enough. Rectal ultrasound is more informative, but it may be contraindicated in some people. Such a study is not carried out for people who have been diagnosed with stenosis of the terminal gastrointestinal tract. Based on this, it becomes clear that none of the methods is ideal, so only their combination can give the most accurate result.
Indications for ultrasound diagnostics
Most often, doctors refer patients to an ultrasound of the intestines if patients have some dangerous symptoms. Indications for the procedure are constipation, fecal incontinence, admixture of blood in the feces, neoplasms in the intestines that are palpable, displacement of the organ, which was revealed by the X-ray method, rectal deformity, endometriosis (in women).
Preparation for ultrasound examination
It is important to understand that any examination of the intestine should be carried out only after preparation. Ultrasound also requires preliminary preparation. This procedure is performed after an enema and on an empty stomach. If the patient has constipation, then it should be disposed of, as well as remove gases from the intestines.
If a person has severe flatulence, then it is necessary to refrain from products that cause increased gas formation. You need to refuse this food for 2-3 days. The list of these products includes: dairy products, yeast products, legumes, as well as products containing a large amount of fiber.
In addition, enterosorbents should be taken: coal, smectite, espumizan. In order for food to be better digested in the stomach, you can take enzyme preparations that a doctor can prescribe.
The process of preparing for an ultrasound of the intestine also depends on the method of examination.
During a superficial examination, it is important to refuse food and drinks 5-7 hours before the procedure, you need to drink 1 liter of non-carbonated filtered water without gas or unsweetened tea 1 hour before the procedure. Immediately before the procedure, you should stop smoking, chewing gum and lollipops.
For ultrasound with contrast, an enema should be given before the procedure in the evening. Ultrasound examination through the rectum is possible with a cleared intestine and an unfilled bladder. It is worth noting that the cleansing procedure can be done with an enema or an osmotic laxative can be used. At the same time, long breaks between meals should not be observed.
As for nutrition, these questions should be clarified with the doctor immediately before the study. Quite often, the intestines are examined together with the stomach and gastrointestinal tract. In such a case, it is not allowed that there are food residues in the digestive tract. If there is a possibility that a double study is required, then it is better to approach this issue as seriously as possible.
Ultrasound
Ultrasound examination of the rectum through the wall of the abdomen is a procedure that is familiar to many. The patient should expose the abdomen, lie on the couch. The doctor must apply a special gel to the skin of the abdomen and then examine the organ using a sensor.
Ultrasound with contrast is performed in a different way:
- The patient should remove clothing below the waist and take a comfortable position on the couch. The doctor must first examine the intestines in the usual way, using a probe (through the abdominal wall).
- Next, the patient should lie on his side, with his back to the doctor. The doctor must inject sterile saline (2 liters) into the intestine through the catheter, and then conduct the usual transabdominal examination. This is done so that the walls of the intestine can straighten out under the pressure of the liquid and make it possible to examine all parts of the organ.
- After emptying the bowels, the doctor should again examine the organ using ultrasound diagnostics.
If a conventional ultrasound examination is familiar to everyone, then the procedure with an endorectal probe can cause fear and questions in a person. In ultrasound through the anus, there is nothing dangerous and scary. A thin sensor, which is specially designed and designed for such manipulations, is inserted into the anus at a distance equal to 10-13 centimeters. It does not cause pain to the patient and is quite safe. The divisions on the sensor allow the doctor to control the depth of its insertion. During the procedure, the patient should lie on his side and keep his knees close to his chest.
What can be found?
A healthy rectum on ultrasound is a rounded, slightly elongated organ with a rim that extends from the muscle layer. Ultrasound scans it in transverse and longitudinal sections. During the examination, the doctor can assess the state of the intestine on the monitor of the apparatus: its size and shape, the location of the organ relative to others, the thickness and structure of the walls, the length of the intestine segments, the condition of the tissues, the size and structure of the lymph nodes, the presence of neoplasms, scars, inflammatory foci.
Normally, scars, foci and neoplasms should not be in the intestines, the size and structure should also comply with the norms.
During the study, the doctor must make a detailed description of the intestine and make a presumptive diagnosis. Further study of the results should be carried out by the proctologist, who prescribed tests and examinations for the patient.
An examination can either confirm a pre-diagnosis or refute it. In addition to possible neoplasms and noticeable changes in the size of the organ, ultrasound can reveal the following pathologies: appendicitis, colitis, intestinal bleeding, hematomas in the walls of the colon, tumors, paraproctitis, intestinal obstruction, diverticula, intussusception, and so on.
If an oncological formation is found in the human intestine, ultrasound can help clarify its localization, prevalence, and the presence of metastases, including lymph nodes.
In preparation for surgery in the case of an oncological neoplasm, ultrasound allows you to determine the location of the upper pole of the tumor and its size. This information is necessary before planning the operation and to determine the optimal approach to the neoplasm.
After surgery, ultrasound is done to monitor the organ and to detect possible recurrence.
There is also an ultrasound screening of the intestine. It is not carried out according to direct indications, but for preventive purposes. Indirect indications include: heredity, old age.
In such cases, it is recommended to carry out ultrasound diagnostics by the endorectal method, since neoplasms in the rectum can be clearly seen with a cavity sensor. The purpose of preventive research is to exclude the oncological process in the organ. Regular scanning allows you to assess the possible risk of developing cancer and notice changes in a timely manner.
Ultrasound examination of the intestine in children
Bowel dysfunction can occur in both adults and children. It is worth noting that infants may suffer from congenital anomalies in the development of the gastrointestinal tract. Ultrasound is the safest and most gentle method for checking a child’s intestines.
Children may be referred for ultrasound if the following diseases are suspected: irritable bowel syndrome, Crohn’s disease, Hirschsprung’s disease, colitis, dolichosigma.
Preparing a child for an ultrasound
Before the procedure, the child must prepare for its implementation. First of all, it concerns nutrition. Parents should provide the child with diet food 2-3 days before the ultrasound, as well as give drugs that reduce gas formation. The name of the drug and dosage should be told by the attending physician. If the child does not suffer from constipation, then doing an enema is optional.
Immediately before the ultrasound examination, the child should be a little hungry. The duration of such a “hunger strike” depends on age:
- if the child is breastfeeding, then you need to skip one feeding before the procedure;
- if the baby is 1-3 years old, then the break in eating should be reduced to 4 hours;
- if the child is from 3 to 14 years old, then the last meal should be 6 hours before the procedure.
It is worth noting that 1 hour before the procedure, you need to stop drinking.
Advantages of intestinal ultrasound
Ultrasound diagnostics of the rectum is not as informative diagnostics as colonoscopy and X-ray irrigoscopy. However, ultrasound is superior to other methods of examining the intestines in many ways. First of all, we are talking about safety, because ultrasound can be done repeatedly, and a study is prescribed even for newborn babies and pregnant women.
Such a sparing diagnosis is recommended for elderly patients and people with weakened immune systems. If the patient has a pronounced pathology, then a more thorough examination is prescribed, in the form of x-rays and endoscopy.
Patient reviews indicate that the procedure is not the most pleasant, but in comparison with colonoscopy, there is practically no discomfort. Unpleasant sensations arise only when the sensor is inserted, and during the study there is no pain. The duration of the procedure is approximately 10 minutes.