Key Hospitalist Clinical Practice Guidelines in 2017

John Anello; Brian Feinberg; John Heinegg; Yonah Korngold; Richard Lindsey; Cristina Wojdylo; Olivia Wong, DO

Disclosures

January 16, 2018

In This Article

Gastrointestinal Ultrasonography

European Federation of Societies for Ultrasound in Medicine and Biology

For a complete examination of the bowel, both a low and high resolution probe are needed.

A probe with a frequency above 5 MHz should be used when measuring wall thickness.

Color Doppler imaging should be used to evaluate the vascularization of pathological bowel wall.

Contrast-enhanced ultrasound of the bowel can be used to separate vascular from avascular intestinal or peri-intestinal lesions, including abscesses.

Ultrasound elastography can be used to evaluate the stiffness of pathological thickened bowel.

A standard examination of the intestine does not need specific preparation.

Fasting > 6 hr is recommended before measuring splanchnic blood flow.

Overnight fasting is recommended before assessing gastrointestinal motility.

A bowel wall thickness <2 mm (not the cut-off value for pathology) could be considered as normal when measured in the normal filling state, except in the duodenal bulb and rectum.

Bowel wall thickness should be measured perpendicular to the wall from the interface between the serosa and proper muscle to the interface between the mucosa and the lumen.

A resistive index in the superior mesenteric artery between 0.80 and 0.89 should be considered normal.

A peak systolic velocity of the superior mesenteric artery (SMA) between 80 and 220 cm/sec should be considered normal.

Transabdominal ultrasound can be used to assess the normal bowel anatomy, vascularization, and luminal width.

The anatomical location of the bowel, peristalsis, and luminal content can be assessed by gastrointestinal ultrasound.

Reference

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