Generality
Abdominal ultrasound is a diagnostic imaging technique that investigates the morphology and state of health of abdominal organs through the use of ultrasound.
- In particular, the ultrasound of the upper abdomen examines the liver, the gallbladder and biliary tract, pancreas, spleen, kidneys and adrenals, as well as the main vascular structures and lymph nodes in the region.
- With lower abdominal ultrasound it is possible to evaluate the anatomy and vascular function of bladder, prostate, uterus and appendages.
Abdominal ultrasound is a non-invasive and well tolerated examination, with high diagnostic accuracy and low cost. For these reasons it represents the first screening method for the study of the abdomen.
Main indications for abdominal ultrasound
The health conditions that induce a doctor to prescribe abdominal ultrasonography are varied and numerous. For example, the most common operational indications are related to the detection of suspicious symptoms or alterations of the hematochemical indices attributable to the functionality and state of health of the organs investigable by abdominal ultrasound.
Indications with Urgency Character
- Presence of abdominal or back pain, a pulsating abdominal mass and hypotension: characteristic symptomatic picture of abdominal aortic aneurysm, a pathological dilatation - of this large vessel that carries oxygen-rich blood to the abdominal and pelvic organs, as well as in the lower limbs. The main culprits of this disease, very dangerous but often asymptomatic, are represented by a smoking habit, male sex, age over 60, familiarity with this disease and the presence of other arterial diseases (angina, arteriosclerosis, arterial hypertension, etc.).
Abdominal ultrasound for screening of the aortic aneurysm (in this case lacking the urgency) is recommended for all men between the ages of 65 and 75, as long as they are smokers or ex-smokers. The same applies to male subjects over the age of 60 who are siblings or children of patients with aneurysms.
- Significant weight loss accompanied by abdominal pain: may be a sign of a serious organ malfunction (generally liver) or a malignant mass.
- Abdominal trauma following accidents.
- New-onset cholestasis: obstruction of bile flow in the liver or extrahepatic level; it manifests itself with abdominal pain sometimes with sudden and violent onset (abdominal colic), digestive difficulties, poor appetite, jaundice, light coloration of the stool and dark urine.
- Recent onset swelling / mass (excluding soft parts): possible indication of malignant or benign tumors, cysts or abscesses, which can be distinguished from each other by abdominal ultrasound.
- Non-phlogistic macrohematuria: significant presence of blood in the urine, such as to give them a frankly red or brown appearance. The pathologies most frequently associated with the discovery of blood in the urine are the presence of calculi, neoplasms or inflammations in the kidney, bladder or urinary tract. Hematuria can also be linked to tuberculosis, cystitis, use of anticoagulant drugs, polycystic kidney disease, prostatitis, prostate adenomas or traumas involving the kidney and / or the urinary tract.
- Uroseptic fever: fever linked to the presence of urinary tract infections, with transient entry into the bloodstream of pathogens. It manifests with irregularly intermittent fever with high febrile peaks (39-40 ° C), to which the symptoms of urinary infection are added.
Other possible indications
Laboratory parameters indicative for abdominal pathology (amylase, lipase, trypsin, direct and indirect bilirubin, transaminase, creatinine, tumor markers ...), biliary / renal colic, recent and recurrent low back pain with microematuria, hepatomegaly, hepatic steatosis, ascites, cirrhosis, hepatitis, fever of unknown origin, jaundice, gallstone or gallbladder stones, pancreatitis, suspicions of various types of cancer, monitoring of therapeutic efficacy or state of health of an organ after transplantation.
The so-called operative abdominal ultrasound can be performed with diagnostic or therapeutic purposes, for example to guide the needle route during a biopsy, a hepatic or biliary drainage, a paracentesis or the treatment of tumors by radiofrequency hyperthermia or laser.
How does it work
Ultrasound is a non-invasive diagnostic imaging technique based on ultrasound exposure of the body area to be examined. This region is bombarded by high-frequency sound waves, imperceptible to the human ear, absolutely harmless and which have nothing to do with the dangerous radiation used during x-rays.
Through this technique, a beam of ultrasounds (so called because they cannot be heard by the human ear) is projected onto the body area to be examined, thanks to a special probe. At this point the tissues affected by sound waves reflect them in varying degrees depending on their consistency; therefore, by picking up the ultrasounds reflected by the same probe that generated them, and converting them into electrical signals, it is possible to process them informally to reconstruct the morphology of the tissues and organs studied.
How it is performed
During an abdominal ultrasound the patient is typically in a supine position, lying on his stomach on the examination table. The painless procedure involves the sliding of the ultrasound probe on the abdomen previously sprinkled with a transparent gel, which has the purpose of improving the contact between the transducer and the skin, eliminating air pockets. The probe, operated manually by the operator, is then pressed against the skin of the abdomen from various angles, concentrating on those of greatest diagnostic interest.
The ultrasound examination is usually completed in 30 minutes.
Preparation
Since the excessive presence of intestinal gas can limit the accuracy of the diagnostic examination, in the two / three days prior to abdominal ultrasound the patient must limit the consumption of all those foods that can cause problems of meteorism and flatulence (such as those rich in fiber and slag). He must therefore refrain from the consumption of legumes (lentils, beans, broad beans, chickpeas, peas), milk and dairy products, vegetables, tubers, grapes, various cheeses, bread and pasta (both allowed with extreme parsimony), whole grain products and fermented foods. These days you should also avoid carbonated drinks, limited nervine drinks (tea, coffee, hot chocolate) and of course abolished the consumption of alcohol. When approaching abdominal ultrasound, the consumption of meat, fish, eggs, fruit without peel (with the exception of grapes), moderately mature cheeses and smooth mineral water is permitted. In some cases (transrectal ultrasound), it is advisable to take a laxative the evening before the exam or to undergo a cleansing enema, while in the previous two days the presence of gas in the intestinal tract can be reduced by taking simethicone (eg Mylcon ®) or charcoal. In the event that the patient has to undergo a complete abdominal ultrasound or only the lower abdomen, it may also be required to drink one liter of non-carbonated water in the hour preceding the examination, and retain the urine until the end of the same.
On the day of the exam, the patient must have been in the fasting clinic for at least eight hours, during which time he can only drink non-carbonated water. All documentation relating to any exams previously carried out must be taken to the clinic when the abdominal ultrasound is performed.
