Examining the gastrointestinal (GI) tract using ultrasound

Start performing your own gastrointestinal ultrasounds with this video by Dr Nikolaus Mayr. Learn how to choose a probe based on your patient, how to angle your probe to obtain optimal views, and how to use that probe to journey through the entire gastrointestinal tract when required.

Want to learn how to perform your own abdominal ultrasounds and interpret your findings? Take our Abdominal Ultrasound Essentials course and you'll become a pro in no time. Dr Nikolaus Mayr–the Chief Resident of Radiology at the Hospital of the Brothers of St. John of God in Salzburg–will guide you through the fundamentals of abdominal sonography.

[00:00:00] Now, I will show you the standard ultrasound of the gastrointestinal tract. If you have obese patients, you will definitely use the curved array probe. But because our model, Kim here, is very slender, we will use the linear probe. I will apply a lot of ultrasound gel and then I will start in the left epigastrium, like this and here

[00:00:30] you can see the stomach. You see the walling of the stomach. Here, you see the air in the lumen and as it goes towards the pylorus, the walling gets thicker. Then the next structure you can find is the duodenum. As you can see here, there's air structure with the subtle walling, as the walling

[00:01:00] gets less muscular. And then you go down and you find the pancreas head, right here, in the center of the picture. And go around to the lower side of the epigastrium, where you can then find the jejunum, the small intestine parts. As Kim hasn't eaten, you will see that the peristalsis, on the

[00:01:30] small intestine structures, is rather diminished and they are not really moving. When I tell him to hold his breath, you can see that the peristalsis is very subtle, right here. Move down lower and go over to the right lower side of the abdomen, where we can find the third part of the small intestine, the ileum, you can see here.

[00:02:00] Also, not very much of peristalsis. And then we move over to the outer, right side of the lower abdomen, where we can find an air-filled structure, here, with less walling, where the wall is very subtle and this is the ascending colon and the cecum. We move up to the right colonic flexure. Take a deep breath and hold it. Now, you can see,

[00:02:30] here, is the right colonic flexure and then we tilt the probe like this and follow this structure, this air structure you can see, here, over through the middle to the other side of the abdomen, and this is the transverse colon going right over to the other side of the abdomen. Exhale again. Take a deep breath again. And then you see the left colonic flexure, right here,

[00:03:00] going around and tilt it again into a cross-section and then we follow the descending colon. You can see, here, down until we get to the sigmoid colon, that will go over to the middle again. You can see, here, in a cross-section. And then we turn around again into a cross-section, like this and go down and then the sigmoid colon, goes over

[00:03:30] into the rectum, which we can see behind the bladder, down here.