Abdominal Ultrasound How, Why and When by Jane A. Smith (formerly Bates) MPhil DMU DCR

By Jane A. Smith (formerly Bates) MPhil DMU DCR

As an increasing number of practitioners are hoping on ultrasound as an permitted, secure, and not pricey diagnostic software in daily perform, its use in diagnosing stomach difficulties is readily expanding. This up to date variation comprises insurance of simple anatomy, method, and ultrasound appearances, as well as the most typical pathological tactics. It serves as either a pragmatic, clinically appropriate guide and source for execs, in addition to a useful textbook for college kids getting into the sector. * Over 500 illustrations and top quality scans truly express stomach anatomy. * functional and clinically suitable insurance addresses the worries of either practitioners and scholars. * Succinct, finished chapters show details.

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12), which is more readily recognized on ERCP than ultrasound. CBD = common bile duct. Further management of gallstones passing into the small intestine may impact in the ileum, causing intestinal obstruction (Fig. 11B). Biliary reflux and gallstone pancreatitis A stone may become lodged in the distal common bile duct near the ampulla. If the main pancreatic duct joins the CBD proximal to this, bile and pan- ERCP demonstrates stones in the duct with greater accuracy than ultrasound, particularly at the lower end of the CBD, which may be obscured by duodenal gas and also allows for sphincterotomy and stone removal.

Qxd 6/30/04 26 5:37 PM Page 26 ABDOMINAL ULTRASOUND CD HA A HA PV CD The direction of flow is normally hepatopetal, that is towards the liver. The main, right and left portal branches can best be imaged by using a right oblique approach through the ribs, so that the course of the vessel is roughly towards the transducer, maintaining a low (< 60˚) angle with the beam for the best Doppler signal. 5 The diameter increases with deep inspiration and also in response to food and to posture changes. An increased diameter may also be associated with portal hypertension in chronic liver disease (see Chapter 4).

B) The focal zone has been moved to the level of the stones, allowing the shadow to be displayed. ● ● The machine settings must be compatible with demonstrating narrow bands of shadowing. The fluid-filled gallbladder often displays posterior enhancement, or increased throughtransmission. If the echoes posterior to the gallbladder are ‘saturated’ this will mask fine shadows. Turn the overall gain down to display this better (Fig. 6). Some image-processing options may reduce the contrast between the shadow and the surrounding tissue, so make sure a suitable dynamic range and image programme are used.

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