Ultrasonic scanning in the diagnosis of space-occupying lesions of the upper abdomen

Abstract

During the last four years, a total of about 2,000 ultrasonic scans of the abdomen, 1,712 of them in the upper abdomen, have been performed at the ultrasonic laboratory, surgical department H, Gentofte Hospital. The experience from the patient material is reviewed, leading to a discussion of the possibilities and limitations in the diagnosis of various pathological conditions in the upper abdomen. It may be said that, in general, an ultrasonic picture can be obtained in the case of space-filling processes, whether solid or cystic tumours, abscesses or haematomas, if these are of an order of magnitude of 2–3 cm or more and if they are not covered by gas-filled intestines. The problems associated with the ultrasonic diagnosis of pathological conditions in the individual organs are reviewed, and in addition to the normal findings, ultrasonic pictures are presented of liver metastases, liver cirrhosis with ascites, hydrops vesicae felleae, gall-stone, pancreatic tumours and pancreatic cysts, splenomegaly, subcapsular haematoma of the spleen, retroperitoneal tumour, aortic aneurysm, renal aplasia, hydronephrosis, renal tumour, renal cyst, phaeochromocytoma, rectus sheath abscess and an intra-abdominal haematoma. In brief, it may be concluded that after a rather prolonged period of training the method has now achieved considerable clinical value in many fields, as a supplement to conventional radiology. Considerable research tasks are still waiting to be solved in this field, before the possibilities of ultrasonic scanning can be fully utilized in medical and surgical diagnosis.