Gastrointestinal Sonography

 A sagittal and transverse view of the flow of the Polaris is the stomach.

Stomach lining here with the gut signature you see all the layers this is the longitudinal very thick muscle you would measure from here to here and from here to here and then this is transverse target light lesion and then anterior - it is the stomach give you get a little bit of liver here's another case transverse.

 Longitudinal on the floor your transverse on the epigastric region of the belly so here you got the Caloris and lung you got your gallbladder right here piece of the liver you got air in the stomach fluid is the most of the muscles 0.5 or five millimeters the length was 24 millimeters or 2.4 centimeters so these have also been called they appear like a little cervix

 The small intestine a few things you can see would be a small bar into this section which is an intermittent condition it goes away on its own doesn't require treatment inflammatory bowel disease necrotizing enterocolitis Henoch-schooling purpura Meckel's diverticulum and duplication cysts to name a few with booth and itis it's not very commonly seen on autism you can't see it it's an information that lubing.

common symptoms are epigastric pain nausea bloating and causes are drugs non-steroidal anti-inflammatory drugs and alcohol can cause information of the duodenum also infection stress and in some cases radiation if it's focused to that to that region

Sagittal on the abdomen here you got this mass this thick-walled mass here and it turned out to be the duodenum you can follow it back to the stomach here you can see the common bile duct was also prominent not a largely prominent and here is a corona like view through the pancreas

 The second part of the dude even the first part was here there wasn't that as thickened and then here's your red kidney and then gas or looting artery at the head of the pancreas in your portal vein all right so small about it to the section.

Transient is it incidental finding for other reasons you might see they might order an ultrasound for an appendix or for all four forward into the section that you might notice that you have a smaller into the session like lesion but usually not in the right upper right lower quadrant where the Filioque Alex usually are but is incidental they're smaller than the large bowel intersections so usually the mean diameter.

 The right upper quadrant because you got the development right here yeah this intussusception so target like nation let's get donut or bull's eye but it's measuring one point seven centimeters is kind of small and here it is in longitudinal and then 15 minutes later it wasn't there anymore so if you do see this small bottle into the section

 On the left upper left lower quadrant or midline that'd be an epigastric or pelvic region just wait measure it put Doppler on it wait and see if it goes away by itself they typically do here's another case three real female let upper quadrant so vo colleague if you remember the ilium in the colon is on the right lower part of the abdomen, this is in the left upper quadrant nearby the spleen you have a small target leg lesion imagine I don't have the measurements here but you can tell it's small and here it is in

Sagittal you can see going into itself right here and then 15 minutes there is a month and this patient was asymptomatic and then this is another patient which had a regular into the session there are two years old they presented with abdominal pain intermittently and jelly-like stools so as diarrhea with a little bit of blood here's right upper quadrant you have a large target like lesion and then you get compared side by side but he also had incidentally a small bowel intersection in the left lower quadrant

Longitudinal image of the colon or the Emil colic region you see the bowels very distended is a lot of material in it and there's some thickening here and in here and if you notice this increased fat especially right here you can definitely notice it right here this increased fat and it's also increased in echogenicity if it was everywhere even in the parts and the right upper quadrant here you see a little bit of bowel right kidney liver and then all this set which is echogenic usually a pagina fat meats called also called fat stranding means that there's an inflammatory change that's causing the fancy to become a demitasse or filled with like lymphatic fluid that causes the increase Dec Regina City all right

In the longitudinal image here you see the anterior wall of the colon and then the

ileum right here with some mesenteric fat and a lymph node so this is what they call the pseudo kidney sign because it has similar periods to a kidney with the sinus fat and then the cortex subcases looked much more than a Seattle

 In longitudinal so you have the large bowel outside and then here we have the ileum within it and you also have many lymph nodes so a lot of times you will see lymph nodes sometimes you might not see it within the interception but you will see a lot of mesenteric lymph nodes

 A sagittal you got your sauce muscle intestine here and longitudinal lymph nodes all enlarged again psoas muscle Neff node Bao lymph node bowel here's another one lymph node and then Snowdon if node it's very common all right I'm not going to go over appendix because I have a separate abdominal pain

 The color Doppler images on a without color somebody who's new to GI ultrasounds might think this is a hit dissection but if in real-time you'll see the SMA will be in the center and it'll be pulsing so if you stay there you'll notice that there's something a little different going on than an intussusception, if you put on the colored upper you have this whirlpool sign and here's another one so you see

all the concentric rings of blood

vessels rubbing around and just pretty

much what happens you have the

intestines with the blood vessels and

then they twist around and then this

part of the bowel from you know

congestion of the blood was not able to are

able to escape an order your Bloods.