Why do children start with an ultrasound?
In children, gastroscopy often requires medical sedation, and this in itself is a reason to seek a non-invasive alternative for the initial assessment. Ultrasound in a child works even better than in an adult: a thin abdominal wall and a small amount of adipose tissue provide excellent image quality, and the examination is painless and does not require preparation, except for a feeding break.
The main indication in infants is persistent regurgitation and vomiting. Ultrasound allows you to measure the thickness and length of the muscle layer of the pylorus and confirm or exclude congenital hypertrophic pyloric stenosis - a condition that requires surgical treatment and is dangerous if diagnosed late. The accuracy of the method in this matter is very high, and it is this method that is the diagnostic standard.
In older children, the study is used for abdominal pain, belching and vomiting: the wall thickness, evacuation rate and the presence of duodenogastric reflux are assessed. As in adults, ultrasound does not replace endoscopy if peptic ulcer or Helicobacter pylori infection is suspected, but it helps to decide whether it is needed.
Ultrasound capabilities
Ultrasound remains the first choice for imaging in almost every situation: it is accessible, safe, does not require radiation, and provides images in real time. It perfectly shows parenchymal organs, fluid formations, walls of hollow organs and soft tissues, and in Doppler mode, blood flow in the vessels.
A separate advantage is the possibility of dynamic tests: the doctor can ask you to strain, change your body position, fill or empty an organ and see how the picture changes. Neither computed tomography nor magnetic resonance imaging provide such an opportunity.
What influences the quality of research
The main enemy of ultrasound is gas: it completely reflects the wave. Therefore, distended intestines can make the pancreas, aorta, and retroperitoneal structures invisible. For the same reason, preparation for examining the abdominal cavity is not a formality, but a condition for a reliable result.
Severe obesity, postoperative scars, bandages and open wounds in the area of interest also have an effect. If the picture turns out to be uninformative, the doctor indicates this in the protocol and recommends an alternative method - computed tomography or magnetic resonance imaging.
Doppler mode
Dopplerography shows the movement of blood: color mapping reflects the direction of flow, spectral analysis measures velocities and resistance indices. This allows you to assess the patency of the vessel, identify stenosis, thrombus, aneurysm, pathological reflux and the nature of the blood supply to the formation.
Increased blood flow in Doppler mode is an important sign of active inflammation or tumor growth, which is why many organ studies are supplemented with Doppler as a mandatory part of the protocol.