Word of the Day – Ascites

Gulfcoast Ultrasound Institute - World of the Day

Ascites

Bowel and Kidney AscitesThe accumulation of serous fluid anywhere in the peritoneal cavity. Simple ascites should appear anechoic accumulating in the most gravity dependent portion of the abdominopelvic cavity.  The examiner should employ the FAST protocol similar to use in the trauma exam to locate any possible fluid present.

To learn more about Ascites, and how to identify it during your evaluations, check out upcoming that will provide hours of .

 

 

Intestinal Ischemia: US-CT findings correlations

Intestinal Ischemia: US-CT findings correlations.

Reginelli A, Genovese E, Cappabianca S, Iacobellis F, Berritto D, Fonio P, Coppolino F, Grassi R.

Second University of Naples, Department of Clinical and Experimental Internistic F, Magrassi – A, Lanzara, Naples, Italy. reginelli@tin.it.

Abstract

BACKGROUND:

Intestinal ischemia is an abdominal emergency that accounts for approximately 2% of gastrointestinal illnesses. It represents a complex of diseases caused by impaired blood perfusion to the small and/or large bowel including acute arterial mesenteric ischemia (AAMI), acute venous mesenteric ischemia (AVMI), non occlusive mesenteric ischemia (NOMI), ischemia/reperfusion injury (I/R), ischemic colitis (IC). In this study different study methods (US, CT) will be correlated in the detection of mesenteric ischemia imaging findings due to various etiologies.

METHODS:

Basing on experience of our institutions, over 200 cases of mesenteric ischemia/infarction investigated with both US and CT were evaluated considering, in particular, the following findings: presence/absence of arterial/venous obstruction, bowel wall thickness and enhancement, presence/absence of spastic reflex ileus, hypotonic reflex ileus or paralitic ileus, mural and/or portal/mesenteric pneumatosis, abdominal free fluid, parenchymal ischemia/infarction (liver, kidney, spleen).

RESULTS:

To make an early diagnosis useful to ensure a correct therapeutic approach, it is very important to differentiate between occlusive (arterial,venous) and nonocclusive causes (NOMI). The typical findings of each forms of mesenteric ischemia are explained in the text.

CONCLUSION:

At present, the reference diagnostic modality for intestinal ischaemia is contrast-enhanced CT. However, there are some disadvantages associated with these techniques, such as radiation exposure, potential nephrotoxicity and the risk of an allergic reaction to the contrast agents. Thus, not all patients with suspected bowel ischaemia can be subjected to these examinations. Despite its limitations, US could constitutes a good imaging method as first examination in acute settings of suspected mesenteric ischemia.

 

References:
See full article at pubmed.gov

Hot Tips – Gallbladder or Duodenum?

One of the most common pitfalls in gallbladder sonography is confusing the proximal duodenum for an abnormal gallbladder.  Sonographers also struggle to demonstrate gallstones when they are located in close proximity to the GB neck. Theresa Jorgensen, RDMS, RDCS, RVT Program Manager at Gulfcoast Ultrasound Institute, will discuss the  “rolling stones” sign to help demonstrate non-obstructed true-luminal gallstones to accurately distinguish between the gallbladder and GI tract.

For more educational information like this, check out our upcoming Introduction to Abdominal and Family Medicine Ultrasound seminars and emergency / critical care ultrasound at Gulfcoast Ultrasound Institute.