Chapter 10The Gastrointestinal Tract.ppt

This condition can lead to ischemia and gangrene of the bowel. Consequently, color Doppler may be utilized to determine if blood flow is present within the intussusception. Flow should be present within the bowel wall with higher gain settings. Treatment for intussusception is by means of an air or contrast enema. If gangrene is suspected, surgical intervention is warranted. An intestinal obstruction may be incidentally noted during a sonographic examination of the abdomen. There are two types of intestinal obstructions: mechanical and non-mechanical. A mechanical obstruction results from a bowel being physically blocked by something. A non-mechanical obstruction or paralytic ileus is when the bowel lacks normal peristalsis. Sonographically, an intestinal obstruction appears as distend fluid-filled loops of bowel. Occasionally, an abrupt termination point of the distended bowel may be identified with sonography, though bowel gas may inhibit this finding. Peristaltic motion may also be increased in cases of mechanical obstruction, with signs of to-and-fro motion of the intraluminal contents. Though rarely identified sonographically, masses of various ingested material may cause intestinal obstructions. These are referred to as bezoars. Bezoars that are more often found in pediatric patients, trichobezoars, consist of ingested hair. Pediatric patients may also suffer from lactobezoars, which are bezoars that consist of powdered milk that has not been adequately mixed with water. Bezoars that consist of vegetable material are called phytobezoars and are more often found in older patients. Sonographically, bezoars will appear as complex masses with varying degrees of acoustic enhancement and posterior shadowing depending on their structure. Crohn’s disease is an autoimmune disorder characterized by periods of inflammation of the gastrointestinal tract. Its cause is unknown. This disease usually involves the terminal iluem, though it can affect any part of the g