Abdominal ecography

An abdominal ultrasound is one of the imaging investigations that the specialist recommends in order to establish the diagnosis in the case of a patient with gastroenterological problems and more.

An abdominal ultrasound is an ultrasound-based imaging investigation that examines intra-abdominal organs, vessels, and tissues. The abdominal ultrasound is a quick, non-irradiating method of diagnosis that can be repeated whenever needed and is not painful. The device (called a probe) is applied to the patient’s body and emits ultrasound directed at the abdominal organs and tissues and then receives the reflected waves and transmits them back to the ultrasound unit. The images obtained are in shades of gray, black and white.

When is abdominal ultrasound indicated?

The abdominal ultrasound is the first useful investigation in examining a patient with abdominal or lumbar pain, which is also the most common cause for an abdominal ultrasound. Other situations or symptoms in which an abdominal ultrasound is indicated are:

• periodic ultrasound evaluation with the role of prevention in the absence of any sign or symptom of the disease;
• vomiting;
• increase of the volume of the abdomen;
• tumor formations that are palpable in the abdomen;
• persistent bloating;
• unexplained weight loss;
• chronic diarrhea;
• sudden onset of constipation;
• frequent urination;
• diagnosis and monitoring of chronic liver or kidney disease;
• evaluation of the genitals;
• posttransplant of various organs (liver, kidneys);
• oncological monitoring – useful in the early detection of possible tumor recurrences;
• monitoring the effectiveness of some treatments;
• haematological diseases, anemia or other changes in blood tests;
• malnutrition or growth disorders in children;
• following abdominal trauma.

Given the many benefits (no side effects, discomfort, speed, accessibility), the abdominal ultrasound is often the first exploration indicated in digestive disorders and allows guidance of subsequent investigations.

Is special training required before an abdominal ultrasound?

To perform an abdominal ultrasound, the patient must rest for at least 4 hours and consume about half a liter of water an hour before the investigation in order for them to have a full bladder. Ideally, avoid eating foods that bloat the day before the investigation, foods such as fermentable dairy products or raw foods.

After meals, the digestive tract is filled with food and air, which masks the abdominal organs and makes them difficult to examine on ultrasound. Also, after a meal, the gallbladder contracts and evacuates its contents, and can no longer be examined in appropriate conditions. To reduce intestinal gas, the patient can take simethicone or charcoal 2-3 days before and even on the day of the ultrasound. In particular situations of suspicion of gastric, duodenal or pancreatic diseases, the patient may be asked to consume water during ultrasound, thus creating a window for examination of the organs mentioned.

Why is it useful to fill the bladder?

To see the walls and contents of the bladder and to create a window to examine the genitals in women and the prostate in men.

What will the doctor be able to detect with the help of an abdominal ultrasound?

An abdominal ultrasound can be crucial in the final diagnosis of a condition, along with the data obtained from the anamnesis, the clinical examination and the blood tests. The abdominal ultrasound obtains information about the size of the organs, their shape, structure and content; whether the normal appearance of the examined structures falls within a reference range, and changes occurring outside this range may suggest certain conditions.

For example, an increase in the size of organs such as the liver, kidneys, pancreas, spleen may reveal acute or chronic inflammation, be it infectious or toxic. In addition, tumors or cystic formations, fluid in the intra-abdominal cavity, kidney or gallstones, inflammation of the intestines, abdominal hernias, blood clots in large vessels, etc. can be detected. An abdominal ultrasound is also useful in diagnosing acute surgical conditions: acute appendicitis, acute cholecystitis, acute diverticulitis. Also, the abdominal ultrasound is the first investigation necessary in the evaluation of an abdominal trauma, being able to detect ruptures of the organs or large blood vessels, internal hemorrhages or foreign bodies.

There are long-term conditions, so-called chronic diseases, which require regular ultrasound monitoring. One such example is chronic hepatitis and liver cirrhosis. Regardless of the cause, whether infectious, alcoholic or autoimmune, an untreated liver disease progresses from acute inflammation to chronic inflammation, cirrhosis and its complications, and ultimately liver cancer. The role of an ultrasound in this sequence is to stage the initial disease, then to monitor it and to detect its complications early. Generally, advanced liver disease is evaluated by ultrasound at 4-6 months in order to detect nodules that can degenerate into liver cancer.

A periodic ultrasound follow-up is recommended when we find polyps in the gallbladder. These polyps are most often (in 9 out of 10 cases) deposits of fat (cholesterol) in the gallbladder wall and even if they can grow, this happens slowly. Cholesterol polyps do not pose a particular risk, but there is another category of polyps, the adenomatous ones, which can show a rapid growth and run the risk of turning into gallbladder cancer. Therefore, the role of monitoring gallbladder polyps is to identify those with rapid growth and large size that may require surgical removal of the gallbladder.

Chronic pancreatitis is another condition that requires ultrasound monitoring as it poses a risk of developing into pancreatic cancer. Also, hepatic, splenic or adrenal nodules or pancreatic or ovarian cysts benefit from ultrasound follow-ups when, depending on the appearance and characterization by analysis, they do not raise suspicions of malignancy and do not require immediate intervention.

In addition to the usual ultrasound image, in shades of gray, we can bring “color” into ultrasound by using Doppler examination (color or power). This technique evaluates the large abdominal blood vessels, their permeability, the existence of aneurysmal dilatations or blood clots inside. It can also identify the presence of blood vessels in nodules with different locations and thus can help us establish the diagnosis. When using the Doppler technique, the blood vessels appear in red (in Power Doppler mode) or in red and blue (depending on the direction of blood flow in color Doppler mode).

Why do an abdominal ultrasound at DigestMed?

The DigestMed Clinic offers the possibility of performing a high quality abdominal ultrasound with help from state of the art devices that produce high image resolutions. In addition, the device is equipped with a liver fibrosis evaluation program, called elastography, and a contrast-enhanced ultrasound program and thus allows a complete and complex ultrasound scan.

Abdominal ultrasounds are performed at DigestMed by gastroenterologists, doctors that specialize in the diagnosis and treatment of digestive disorders. Since most of the intra-abdominal organs belong to the digestive tract, an abdominal ultrasound performed by DigestMed doctors represents an integration of clinical information and an exploration directed by clinical suspicion. Within DigestMed, this evaluation can be completed by clinical consultation and endoscopic examinations, and thus the complete information necessary for the diagnosis and treatment guidance can be obtained.