What can you see without gastroscopy?
An ultrasound examination of the stomach is performed after the patient drinks a certain volume of liquid: it straightens the cavity and creates an acoustic window through which the wall of the organ becomes visible. The doctor evaluates its thickness and layering, the presence of local thickenings, the condition of the pylorus, the rate of gastric emptying and the reflux of contents from the duodenum back into the stomach.
The method is especially useful where function rather than mucous membrane is important. It shows delayed or accelerated evacuation, pyloric spasm, duodenogastric reflux, indirect signs of duodenostasis, and also allows you to evaluate the stomach with a pronounced gag reflex, when gastroscopy is poorly tolerated.
A fundamental limitation: ultrasound does not see the mucous membrane the way an endoscope sees it. It does not replace gastroscopy if ulcers, gastritis, erosions and tumors are suspected, and it cannot be used to take a biopsy or test for Helicobacter. It is a method of functional assessment and initial screening and not an alternative to endoscopy.
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.