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Lower gastrointestinal bleeding echocardiography and ultrasound

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

There are no specific ultrasound findings associated with lower gastrointestinal bleeding. However, ultrasound can be useful in diagnosing various etiology or conditions responsible for lower gastrointestinal bleeding.

Ultrasound

Ultrasound can be helpful in the diagnosis of lower gastrointestinal bleeding. Transabdominal ultrasound is a non-invasive and repeatable imaging study that can be performed easily without bowel preparation. Findings on an ultrasound suggestive of lower gastrointestinal bleeding include:[1][2][1][3][4][5][6]

Ultrasound findings of various diseases causing LGIB
Disease Site Gut findings Perigut findings
Ulcerative colitis Entire colon or left colon including rectum Preserved stratification Normal perigut fat
Crohn’s disease Caecum including the terminal ileum

Skip lesion

Preserved or lost stratification 

Focal destruction of stratification

Thickening of peri-gut fat, enlarged lymph node 

Abscesses, fistula

Ischemic colitis Descending colon Preserved or lost stratification Normal perigut fat
Infectious colitis Right colon and terminal ileum Preserved stratification Thickening of perigut fat, enlarged lymph node
Colorectal cancer  Localized Lost stratification Normal perigut fat
Stratification: Caused by infiltration of the submucosa by tumour or fat.

References

  1. 1.0 1.1 Shirahama M, Koga T, Ishibashi H, Uchida S, Ohta Y (1994). “Sonographic features of colon carcinoma seen with high-frequency transabdominal ultrasound”. J Clin Ultrasound. 22 (6): 359–65. PMID 8071453.
  2. Lim JH, Ko YT, Lee DH, Lim JW, Kim TH (1994). “Sonography of inflammatory bowel disease: findings and value in differential diagnosis”. AJR Am J Roentgenol. 163 (2): 343–7. doi:10.2214/ajr.163.2.8037027. PMID 8037027.
  3. Lim JH (1996). “Colorectal cancer: sonographic findings”. AJR Am J Roentgenol. 167 (1): 45–7. doi:10.2214/ajr.167.1.8659418. PMID 8659418.
  4. Valette PJ, Rioux M, Pilleul F, Saurin JC, Fouque P, Henry L (2001). “Ultrasonography of chronic inflammatory bowel diseases”. Eur Radiol. 11 (10): 1859–66. doi:10.1007/s003300101065. PMID 11702118.
  5. Danse EM, Jamart J, Hoang P, Laterre PF, Kartheuser A, Van Beers BE (2004). “Focal bowel wall changes detected with colour Doppler ultrasound: diagnostic value in acute non-diverticular diseases of the colon”. Br J Radiol. 77 (923): 917–21. doi:10.1259/bjr/18038687. PMID 15507414.
  6. Kunihiro K, Hata J, Haruma K, Manabe N, Tanaka S, Chayama K (2004). “Sonographic detection of longitudinal ulcers in Crohn disease”. Scand. J. Gastroenterol. 39 (4): 322–6. PMID 15125463.

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