Abdominal ultrasonography: improved image quality with the combined use of a diet and laxatives

Intestinal contents (gas and food particles) are well known to cause problems in abdominal ultrasonography by inducing confusing and inconclusive images. We prospectively studied the effect on the combination of a 2-day low-calorie, low gas-forming diet with laxatives on abdominal sonographic image quality. For a total group of 100 consecutive outpatients, 50 patients (diet-laxative or DL group) were randomly assigned to follow the preparation of a diet and laxatives, and 50 patients (control or C group) served as a control group without any special preparation. The sonographic imaging quality of abdominal organs and retroperitoneal structures was assessed without knowledge of which group the patients were assigned to. The DL group patients showed a significant improvement in visibility of the extra-hepatic common bile duct (p = 0.009), head and body of the pancreas (p = 0.015 and 0.004, respectively), para-aortic region (p = 0.001), and the iliac vessels (p = 0.0005). The combined use of a low-calorie, low gas-forming diet and laxatives improves the abdominal sonographic image quality of the above-mentioned structures to such an extent that the sonographer will be able to make more pertinent statements about the presence or absence of pathology.