Smereczyński Andrzej, Kołaczyk Katarzyna
Ultrasound Self-Study Club, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.
J Ultrason. 2018;18(74):207-211. doi: 10.15557/JoU.2018.0031.
The gastrointestinal tract is an extraordinary human organ in terms of its morphology and function. Its complex structure and enormous length as well as frequent presence of gas discourage many doctors performing ultrasound examination from its exploration. Moreover, there are anatomical structures in multiple locations which can mimic certain abnormalities. It is difficult to present an exhaustive account of the problem of gastrointestinal tract ultrasound imaging errors in a single work; therefore, this study focuses mainly on false positive errors which usually result from a lack of knowledge of anatomical variants of the gastrointestinal tract structure. In the case of the stomach, rugae and muscle layer thickening towards the pylorus have been mentioned, which constitute variants of the structure of this organ examined when empty. Diagnostic pitfalls in the small intestine may include the dudenojejunal flexure (ligament of Treitz), the horizontal part of the duodenum and the ileocaecal valve. The status of the apparent lesions in all of the cases mentioned will be resolved following fluid intake by the patient. In the colon, the varied structure of semilunar folds should be taken note of. Their large thickness can warrant suspicion of wall invasion or a polyp. In addition, the study emphasises the importance of appropriate preparation of a patient for gastrointestinal tract examination since it determines the accuracy of the diagnosis. The authors also take note of common 'sins' of physicians such as hasty examination and failure to comply with the stomach and appendix examination protocol.
就胃肠道的形态和功能而言，它是人体一个非凡的器官。其复杂的结构、巨大的长度以及气体的频繁存在，使得许多进行超声检查的医生不愿对其进行探查。此外，多个部位的解剖结构可能会模拟某些异常情况。在一篇单独的著作中很难详尽阐述胃肠道超声成像错误的问题；因此，本研究主要关注通常由对胃肠道结构解剖变异缺乏了解导致的假阳性错误。以胃为例，已提及胃皱襞和向幽门方向的肌层增厚，这些是该器官在空腹检查时的结构变异。小肠的诊断陷阱可能包括十二指肠空肠曲（Treitz韧带）、十二指肠水平部和回盲瓣。上述所有病例中明显病变的情况在患者摄入液体后将会得到解决。在结肠方面，应注意半月襞结构的多样性。其较大的厚度可能会让人怀疑有肠壁侵犯或息肉。此外，该研究强调了患者为胃肠道检查做好适当准备的重要性，因为这决定了诊断的准确性。作者还注意到医生常见的“错误行为”，如检查仓促以及未遵循胃部和阑尾检查方案。
