Diagnostic Ultrasound - Abdomen and Pelvis

Approach to Bowel Sonography
(Left) Abnormal
circumferential thickening of
the right colon is shown.
Calipers indicate the single
wall thickness. Note the loss
of the stratified layers of the
bowel and lobular outline.
These are hallmarks of
neoplastic disease. (Right)
Corresponding color Doppler
US shows the relatively
hypovascular nature of the
colonic mass . Note linear
arc of gas with reverberation
artifact denoting the
stenosed ulcerated lumen.
Diagnoses: Bowel
(Left) Axial US demonstrates
long segment confluent
thickening of centrally placed
small bowel in a patient with
known Crohn disease.
Thickened segment is
angulated and rigid with
surrounding hyperemic fat .
This makes the thickened
bowel more conspicuous.
(Right) Corresponding US in
the same patient shows
increased vascularity in
keeping with a significant
active inflammatory
component. Note that with
the presence of significant
inflammation, there maybe
loss of the gut wall layers .
(Left) Transvaginal US (TVUS)
shows a distended pelvic
appendix with calcified
appendicoliths in the base,
in keeping with an acute pelvic
appendicitis. This was not
visible on abdominal US, hence
the value of TVUS. (Right)
Thickening of the valvulae
conniventes in the distal
ileum and dilatation of the
distal ileum with fluid are
shown in a patient with known
celiac disease. This reversal of
the small bowel folds and
dilatation with fluid from
impaired motility is clearly
seen and well recognized in
celiac disease.
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