Bowel sonography has been recognized as a powerful diagnostic tool. While ultrasound retains an important role for abdominal evaluation, the use of CT scans is preferred as CT scans are less operator-dependent and allow rapid evaluation of vessels, mesentery, and major organs. Ultrasound is limited by large patient body habitus and availability of qualified sonographers. Recently there has been a focus on resource utilization reduction, providing cost-effective care, and limiting radiation and contrast exposure for abdominal diagnostic tests [1–3]. When compared to CT, the use of ultrasound as a diagnostic tool reduces time to diagnosis and treatment, as well as overall length of stay [4–7].
KeywordsBowel Obstruction Appendicitis Pneumoperitoneum Pyloric Stenosis Intussusception
The peristalsing bowel can be seen on the right side of the clip (see Fig. 27.5). Video courtesy of Ee Tay (MP4 2931 kb)
Pulsations from the iliac artery and vein be used as a landmark for appendicitis ultrasound (see Fig. 27.7). Video courtesy of Ee Tay (MP4 316 kb)
Acute appendicitis with appendicolith. Note the hyperechoic stone with the dark shadow similar to the appearance of a gallstone (see Fig. 27.12). Video courtesy of Jim Tsung (MP4 830 kb)
Acute appendicitis with a rim of periappendiceal edema. Note the large tubular appendix which is highlighted by a halo of hypoechoic edema (see Fig. 27.13). Video courtesy of Ee Tay (MP4 301 kb)
Mesenteric lymph nodes. Note the multiple, relatively hypoechoic, rounded structures without posterior acoustic enhancement (see Fig. 27.14). Video courtesy of Ee Tay (MP4 453 kb)
Peritoneal A-lines. From the peritoneum, note repeating horizontal lines symmetrically spaced similar to what would be seen in normal lung (see Fig. 27.16). Video courtesy of Bret Nelson (MOV 6054 kb)
The pyloris. Note the two muscular walls that are continued from the end of the stomach just to the right of the liver (see Fig. 27.18). Video courtesy of Ee Tay (MP4 292 kb)
How to properly follow the large bowel when performing an intussusception study (see Fig. 27.20). Video courtesy of Ee Tay (MOV 35554 kb)
The target sign of intussusception. Note the hyperechoic circle within the relatively hypoechoic circle representing once piece of towel telescoped within another (see Fig. 27.21). Video courtesy of Ee Tay (MP4 2932 kb)
- 3.Her Majesty’s Stationery Office. Statutory instruments: the ionising radiation (medical exposure) regulations. 2000. No. 1059. http://www.legislation.gov.uk/uksi/2000/1059/pdfs/uksi_20001059_en.pdf. Accessed 17 Jun 2017.
- 8.EU council. Health protection of individuals against the dangers of ionizing radiation in relation to medical exposure. EU directive 1997/43/Euratom. Off J Eur Comm. 1997;Google Scholar