Ultrasound diagnosis is a universal diagnostic method that is used in various fields of medicine. Until recently, it was rather difficult to examine the intestines, and ultrasonography was practically not used in proctology. This is explained by the fact that the lumen of the intestine contains gas that distorts the image. The development of ultrasound technology has allowed to overcome this drawback, and now the ultrasound examination of the intestine is considered one of the most popular measures in the examination and diagnosis. A special role is played by this method in identifying oncological processes.
Types of bowel ultrasound
2 ultrasound methods are used for intestinal imaging: transabdominal and rectal. The transabdominal method involves ultrasound through the abdominal cavity. This method is used without filling the intestines, while contrast is introduced, and the bladder must be filled.
With the rectal method, a rectal probe is used. You can also do intracavitary examination with a vaginal probe. This method is optional and only 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 100% of the result, as in 15% of cases the bladder is not sufficiently filled. Rectal ultrasound is more informative, but it may be contraindicated in some people. Such a study is not conducted for people diagnosed with stenosis of the terminal part of the gastrointestinal tract. Based on this, it becomes clear that none of the methods is ideal, therefore only their combination can give the most accurate result.
Indications for ultrasound diagnosis
Most often, doctors refer patients for an ultrasound examination of the intestines, if patients have some dangerous symptoms. Indications for the procedure are constipation, fecal incontinence, blood admixture in the feces, neoplasms in the intestine, which are palpated during palpation, displacement of the organ, which revealed an x-ray method, rectal deformity, endometriosis (in women).
It is important to understand that any intestinal examination should be carried out only after preparation. Ultrasound also requires advance preparation. This procedure is performed after the enema and on an empty stomach. If the patient has constipation, then you should get rid of it, as well as remove gases from the intestine.
If a person has pronounced flatulence, it is necessary to refrain from products that cause increased gas formation. It is necessary 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, smecta, espumizan. In order to better digest food in the stomach, you can take enzyme preparations that can be prescribed by the doctor.
The process of preparing for ultrasound of the intestine also depends on the method of examination.
During the superficial examination it is important to refuse from food and drinks for 5-7 hours, 1 hour before the procedure you need to drink 1 liter of non-carbonated filtered water without gas or unsweetened tea. Immediately before the procedure is to stop smoking, chewing gum and candy.
An ultrasound with contrast should be given an enema before the procedure in the evening. Ultrasound examination through the rectum is possible with a cleaned intestine and an unfilled bladder. It is worth noting that the cleaning procedure can be done with an enema, or use an osmotic laxative. At the same time there is no need to observe big breaks between meals.
With regard to nutrition, these questions should be clarified with the doctor immediately before the study. Quite often, the intestine is examined along with the stomach and gastrointestinal organs. In such a case, it is not allowed that food remains in the digestive tract. If there is a possibility that double research will be required, then it is better to approach this issue as seriously as possible.
Ultrasound examination of the rectum through the abdominal wall is a procedure that is familiar to many. The patient should expose the stomach, lie on the couch. The doctor must apply a special gel on the skin of the abdomen and then examine the organ with a sensor.
Ultrasound with contrast is carried out in another way:
- The patient should take off his clothes below the waist and take a comfortable position on the couch. The doctor must first examine the intestines in the usual way, using a sensor (through the abdominal wall).
- Next, the patient should lie on his side, back to the doctor. In the intestine through the catheter, the doctor must enter a sterile saline solution (2 liters), and then conduct the usual transabdominal examination. This is done to ensure that the intestinal walls are able to deal with the pressure of the fluid and give the opportunity to inspect all parts of the body.
- After an emptying of the intestines, the doctor must again examine the organ with the help of ultrasound diagnostics.
If conventional ultrasound is familiar to everyone, then a procedure with an endorectal sensor can cause fear and questions in a person. In the 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 give the patient pain and is completely safe. The tick marks allow the doctor to control the depth of his injection. During the procedure, the patient should lie on his side and keep his knees at the chest.
What can be detected?
A healthy rectum on ultrasound is a rounded, slightly elongated organ with a rim that moves away from the muscle layer. Ultrasound scans it in transverse and longitudinal sections. During the examination, the doctor can evaluate the state of the intestines on the monitor of the device: its size and shape, the location of the body relative to others, the thickness and structure of the walls, the length of the intestinal segments, the condition of the tissues, the size and structure of the lymph nodes, the presence of tumors, scars, inflammatory foci.
Normally, there should be no scars, foci and neoplasms in the intestines; the size and structure should also comply with the standards.
During the study, the physician must make a detailed description of the intestines and make a presumptive diagnosis. Further study of the results should be engaged proctologist, who appointed the patient tests and examinations.
A survey can confirm a previously diagnosed diagnosis or disprove it. In addition to possible tumors 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, invagination and so on.
If an oncological formation is detected in a person’s intestine, an ultrasound scan can help to clarify its localization, prevalence and presence of metastases, including lymph nodes.
Preparing for surgery in the case of cancer, ultrasound allows you to determine the location of the upper pole of the tumor and its size. This information is necessary before planning an operation and to determine the optimal approach to the neoplasm.
After surgery, an ultrasound scan is done to monitor the organ and to detect possible relapse.
There is also an ultrasound screening of the intestines. It is carried out not by direct indications, but as a preventive measure. By indirect indications include: heredity, old age.
In such cases, it is recommended to carry out ultrasound diagnostics using the endorectal method, since neoplasms in the rectum can be clearly seen by the abdominal sensor. The purpose of the preventive study is to exclude the oncological process in the organ. Regular scanning allows you to assess the possible risk of cancer and notice changes in a timely manner.
Ultrasound examination of the intestine in children
Abnormalities in the bowels can occur in both adults and children. It is worth noting that babies can suffer from congenital anomalies of the development of the gastrointestinal tract. Ultrasound examination is the safest and most gentle method for checking the children's intestines.
Children may be referred for ultrasound when they suspect the following diseases: irritable bowel syndrome, Crohn's disease, Hirschsprung's disease, colitis, dolichosigmoid.
Preparation of the child for ultrasonography
Before the procedure, the child should prepare for its implementation. First of all, it concerns nutrition. Parents should provide the child with a diet food 2-3 days before the ultrasound, and also give drugs that reduce gas formation. The name of the drug and the dosage should say the attending physician. If the child does not suffer from constipation, then do an enema is not necessary.
Immediately before the ultrasound examination, the child should starve a little. The duration of such a “hunger strike” depends on the age:
- if the baby is nursing, then you need to skip one feeding before the procedure;
- if the baby is 1-3 years old, then a break in food intake 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.
The advantages of intestinal ultrasound
Ultrasound diagnosis of the rectum is not as informative diagnosis as colonoscopy and X-ray irrigoscopy. Nevertheless, ultrasound is much better than other methods of examination of the intestine. First of all, we are talking about security, because ultrasound can be done repeatedly, and even newborn babies and pregnant women are scheduled to study.
Such a gentle diagnosis is recommended for elderly patients and people with weakened immune systems. If the patient has severe pathology, then a more thorough examination is prescribed, in the form of X-rays and endoscopy.
Patient reviews suggest that the procedure is not the most pleasant, but in comparison with colonoscopy, there is almost no discomfort. Discomfort occurs only with the introduction of the sensor, and during the study there is no pain. The duration of the procedure is approximately 10 minutes.
Specialty: pediatrician, infectious diseases specialist, allergist-immunologist.
Total experience: 7 years.
Education: 2010, SSMU, pediatric, pediatrics.
Experience infectious diseases more than 3 years.
He has a patent on the topic “A method for predicting a high risk of the formation of a chronic pathology of the adeno-tonsillar system in frequently ill children”. As well as the author of publications in the journals VAK.