[Ultrasound ileus diagnosis]

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Bowel obstruction presents diagnostic challenges, often requiring prompt therapeutic intervention.
• Differentiating between incomplete/complete obstruction, intestinal obstruction, and paralytic ileus can be uncertain.
• Plain abdominal X-rays have limitations in detecting the underlying cause of bowel obstruction.

Purpose of the Study:

• To highlight the diagnostic value of ultrasound in acute bowel obstruction.
• To compare ultrasound findings with traditional X-ray imaging.
• To emphasize the role of ultrasound in early diagnosis and differentiating causes of ileus.

Main Methods:

• Utilizing ultrasound to identify dilated intestinal loops, gas patterns, and fluid levels.
• Assessing intestinal wall edema, peristalsis (including duplex studies), and contents.
• Detecting stenoses caused by tumors, Crohn's disease, diverticulitis, and other conditions.
• Evaluating for ascites and differentiating small from large bowel obstruction based on anatomical landmarks.

Main Results:

• Ultrasound correlates with X-ray findings of dilated loops and fluid levels.
• Specific sonographic signs like jejunal folds (jejunum) vs. ileocecal valve (ileum) aid localization.
• Ultrasound can identify causes of stenosis (tumors, Crohn's, diverticulitis) and associated findings like ascites.
• Duplex sonography aids in distinguishing mechanical obstruction from paralytic ileus.
• Ultrasound is particularly valuable in early obstruction phases before classic X-ray signs appear, revealing peristaltic and wall changes.

Conclusions:

• Ultrasound provides critical additional information for diagnosing bowel obstruction, especially when X-rays are inconclusive.
• Early ultrasound examination facilitates quicker diagnosis and identification of obstruction causes, enabling timely treatment.
• While ultrasound cannot detect adhesions, it is superior to X-ray in early-stage presentations and differentiating ileus types.