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Gastric Point of Care Ultrasound in Adults: Image Acquisition and Interpretation
Published on: September 22, 2023
Gastrointestinal perforation: ultrasonographic diagnosis
Ff Coppolino1, G Gatta, G Di Grezia
1Second University of Naples, Department of Clinical and Experimental Internistic F, Magrassi - A, Lanzara, Naples, Italy. graziella.digrezia@libero.it.
Critical Ultrasound Journal
|August 2, 2013
Summary
Ultrasonography can detect pneumoperitoneum, a sign of gastrointestinal perforation, using specific echogenic signs. This imaging technique is valuable, especially when avoiding radiation exposure is critical.
Area of Science:
- Abdominal Imaging
- Gastroenterology
- Emergency Medicine
Background:
- Gastrointestinal tract perforations necessitate prompt diagnosis and treatment.
- Various etiologies contribute to perforations, including ulcers, trauma, and neoplasms.
- Pneumoperitoneum is a key indicator of gastrointestinal perforation.
Purpose of the Study:
- To evaluate the utility of ultrasonography as an initial diagnostic tool for pneumoperitoneum.
- To describe the sonographic signs indicative of gastrointestinal perforation.
- To highlight the advantages and limitations of ultrasound in diagnosing perforation.
Main Methods:
- Utilized linear probes in the right upper quadrant for optimal detection.
- Identified free intraperitoneal air as the primary sonographic sign.
- Recognized indirect signs such as bowel wall thickening and ascites.
Main Results:
- Free intraperitoneal air presents as increased echogenicity with artifacts (comet-tail sign).
- Indirect signs include thickened bowel loops, air in fluid collections, and altered bowel motility.
- Ultrasound is operator-dependent and can be limited by patient factors and body habitus.
Conclusions:
- Ultrasonography is a valuable initial test for detecting pneumoperitoneum and potential gastrointestinal perforation.
- It offers a radiation-free alternative, particularly beneficial for pediatric and pregnant patients.
- While CT is more accurate for localization, ultrasound provides crucial early assessment.
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