Is It Worthwhile to Fully Evaluate the Stomach in Every Ultrasound Examination of the Abdominal Cavity?
Subgroup: Volume 8, Issue 1
Date: March 2011
Type: Original Article
Start Page: 7
End Page: 13
- Mahmoud Goudarzi Department of Radiology, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
City, Province: Kermanshah,
Country: IR Iran
Background/Objective: To evaluate the usefulness of abdominal sonography in the fasting state with no hypotonic agents in the detection and exclusion of gastric lesions.
Patients and Methods:One-hundred patients with normal upper gastrointestinal endoscopy, 94 patients with a major gastric abnormality (including 59 intraluminal tumors, three submucosal masses, 29 ulcers, two polyps and one hypertrophied gastric mucosa) and 75 patients with minor gastric abnormalities (mainly gastritis) were enrolled into the study.
Results: Of the 100 normal patients, ultrasound showed four false positive results with 96% specificity of the examination. Within the major gastric lesion group, ultrasound was true positive in 55 of 59 tumors, 15 of 29 ulcers, three of three submucosal masses and the case of giant gastric mucosa. It was negative in the detection of gastric polyps. It could detect only 8% of minor gastric abnormalities.
Conclusion: Abdominal sonography in the fasting state, if carefully performed, is sufficiently accurate in detection and exclusion of major gastric lesions. Therefore, although it cannot replace endoscopic and barium studies of the stomach, careful evaluation of the stomach is recommended in every sonographic evaluation of the abdominal cavity.
Keywords: Ultrasonography;Abdominal Cavity;Gastrointestinal;Endoscopy;Sensitivity;Specificity
Patients with upper gastrointestinal (GI) abnormalities may present with nonspecific symptoms. On the other hand, gastric cancer, in the early stages and when it is surgically curable, usually produces no symptoms and the disease presents regularly at advanced stage. Peptic ulcers may also present with a complication without antecedent symptoms (1-3). Although upper GI endoscopy and barium studies are accepted methods for the evaluation of upper GI lesions, it is not unusual to see a gastric lesion during a routine abdominal ultrasound (US) examination. In fact, US is frequently used as a primary diagnostic test for evaluation of patients with nonspecific abdominal complaints and acute abdominal pain (4-5).To date, many studies have been carried out on the usefulness of US in the diagnosis of gastric lesions, but nearly all of them by means of fluids and/or hypotonic agents to distend the stomach (6-21). We performed this prospective study to assess the usefulness of abdominal sonography in the fasting state and without use of hypotonic agents in the evaluation of the stomach, as is usually occurs in a routine abdominal US examination.