Mistakes in gastrointestinal ultrasound and how to avoid them

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Mistakes in gastrointestinal ultrasound and how to avoid them

Odd Helge Gilja, Andreas Jessen Gjengstø, Kim Nylund, Hilde L. Von Volkmann

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References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Maconi G, Nylund K, Ripolles T, Calabrese E, Dirks K, Dietrich CF, et al. EFSUMB Recommendations and Clinical Guidelines for Intestinal Ultrasound (GIUS) in Inflammatory Bowel Diseases. Ultraschall Med 2018; 39 (3): 304-317.

Nylund K, Maconi G, Hollerweger A, Ripolles T, Pallotta N, Higginson A, et al. EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound. Ultraschall Med 2017; 38 (3):273-284.

Maconi G, Hausken T, Dietrich CF, Pallotta N, Sporea I, Nurnberg D, et al. Gastrointestinal Ultrasound in Functional Disorders of the Gastrointestinal Tract – EFSUMB Consensus Statement. Ultrasound Int Open 2021; 7 (1): E14-E24.

Dirks K, Calabrese E, Dietrich CF, Gilja OH, Hausken T, Higginson A, et al. EFSUMB Position Paper: Recommendations for Gastrointestinal Ultrasound (GIUS) in Acute Appendicitis and Diverticulitis. Ultraschall Med 2019; 40 (2): 163-175.

Nielsen MB, Cantisani V, Sidhu PS, Badea R, Batko T, Carlsen J, et al. The Use of Handheld Ultrasound Devices – An EFSUMB Position Paper. Ultraschall Med 2019;40(1):30-39.

Heldwein W, Sommerlatte T, Hasford J, Lehnert P, Littig G, Müller-Lissner S. Evaluation of the usefulness of dimethicone and/or senna extract in improving the visualization of abdominal organs. J Clin Ultrasound 1987; 15 (7): 455-458.

Pinto PN, Chojniak R, Cohen MP, Yu LS, Queiroz- Andrade M, Bitencourt AG. Comparison of three types of preparations for abdominal sonography. J Clin Ultrasound 2011; 39 (4): 203-208.

Sinan T, Leven H, Sheikh M. Is fasting a necessary preparation for abdominal ultrasound? BMC Med Imaging 2003; 3(1):1.

Ehrenstein BP, Froh S, Schlottmann K, Scholmerich J, Schacherer D. To eat or not to eat? Effect of fasting prior to abdominal sonography examinations on the quality of imaging under routine conditions: A randomized, examiner-blinded trial. Scand J Gastroenterol 2009; 44 (9): 1048-1054.

10.

Hirche TO, Russler J, Schroder O, Schuessler G, Kappeser P, Caspary WF, et al. The value of routinely performed ultrasonography in patients with Crohn disease. Scand J Gastroenterol 2002; 37 (10): 1178-1183.

11.

Nylund K, Hausken T, Ødegaard S, Eide GE, Gilja OH. Gastrointestinal wall thickness measured with transabdominal ultrasonography and its relationship to demographic factors in healthy subjects. Ultraschall Med 2012; 33 (7): E225-e232.

12.

Nylund K, Hausken T, Gilja OH. Ultrasound and inflammatory bowel disease. Ultrasound Q 2010; 26 (1): 3-15.

13.

van Oostayen JA, Wasser MN, Griffioen G, van Hogezand RA, Lamers CB, de Roos A. Activity of Crohn's disease assessed by measurement of superior mesenteric artery flow with Doppler ultrasound. Neth J Med 1998; 53 (6):S3-S8.

14.

Neye H, Voderholzer W, Rickes S, Weber J, Wermke W, Lochs H. Evaluation of criteria for the activity of Crohn's disease by power Doppler sonography. Dig Dis 2004; 22 (1): 67-72.

15.

Spalinger J, Patriquin H, Miron MC, Marx G, Herzog D, Dubois J, et al. Doppler US in patients with crohn disease: vessel density in the diseased bowel reflects disease activity. Radiology 2000; 217 (3): 787-791.

16.

Limberg B. [Diagnosis of chronic inflammatory bowel disease by ultrasonography]. Z Gastroenterol 1999; 37 (6): 495-508.

17.

Jenssen C, Tuma J, Möller K, Cui XW, Kinkel H, Uebel S, et al. [Ultrasound artifacts and their diagnostic significance in internal medicine and gastroenterology – part 2: color and spectral Doppler artifacts]. Z Gastroenterol 2016;54 (6): 569-578.

18.

Calabrese E, Zorzi F, Onali S, Stasi E, Fiori R, Prencipe S, et al. Accuracy of small-intestine contrast ultrasonography, compared with computed tomography enteroclysis, in characterizing lesions in patients with Crohn's disease. Clin Gastroenterol Hepatol 2013; 11 (8): 950-955.

19.

Castiglione F, Mainenti PP, De Palma GD, Testa A, Bucci L, Pesce G, et al. Noninvasive diagnosis of small bowel Crohn's disease: direct comparison of bowel sonography and magnetic resonance enterography. Inflamm Bowel Dis 2013; 19 (5): 991-998.

20.

Dietrich CF, Brunner V, Seifert H, Schreiber-Dietrich D, Caspary WF, Lembcke B. [Intestinal B-mode sonography in patients with endemic sprue. Intestinal sonography in endemic sprue]. Ultraschall Med 1999; 20(6): 242-247.

21.

Hollerweger A, Maconi G, Ripolles T, Nylund K, Higginson A, Serra C, et al. Gastrointestinal Ultrasound (GIUS) in Intestinal Emergencies - An EFSUMB Position Paper. Ultraschall Med 2020; 41 (6): 646-657.

22.

Maconi G, Di Sabatino A, Ardizzone S, Greco S, Colombo E, Russo A, et al. Prevalence and clinical significance of sonographic detection of enlarged regional lymph nodes in Crohn's disease. Scand J Gastroenterol 2005; 40 (11): 1328-33.

23.

Dietrich CF, Hollerweger A, Dirks K, Higginson A, Serra C, Calabrese E, et al. EFSUMB Gastrointestinal Ultrasound (GIUS) Task Force Group: Celiac sprue and other rare gastrointestinal diseases ultrasound features. Med Ultrason 2019; 21 (3): 299-315.

24.

Saevik F, Eriksen R, Eide GE, Gilja OH, Nylund K. Development and Validation of a Simple Ultrasound Activity Score for Crohn's Disease. J Crohns Colitis 2021; 15 (1): 115-124. 25.

25.

Peyrin-Biroulet L, Chamaillard M, Gonzalez F, Beclin E, Decourcelle C, Antunes L, et al. Mesenteric fat in Crohn's disease: a pathogenetic hallmark or an innocent bystander? Gut 2007; 56 (4): 577-583.

26.

Kucharzik T, Wittig BM, Helwig U, Borner N, Rossler A, Rath S, et al. Use of Intestinal Ultrasound to Monitor Crohn's Disease Activity. Clin Gastroenterol Hepatol 2017; 15 (4): 535-542 e2.

27.

Maconi G, Greco S, Duca P, Ardizzone S, Massari A, Cassinotti A, et al. Prevalence and clinical significance of sonographic evidence of mesenteric fat alterations in Crohn's disease. Inflamm Bowel Dis 2008; 14 (11): 1555-1561.

28.

Di Mizio R, Maconi G, Romano S, D'Amario F, Bianchi Porro G, Grassi R. Small bowel Crohn disease: sonographic features. Abdom Imaging 2004; 29 (1): 23-35.

29.

Renfrew DL, Franken EA, Jr., Berbaum KS, Weigelt FH, Abu-Yousef MM. Error in radiology: classification and lessons in 182 cases presented at a problem case conference. Radiology 1992; 183 (1):145-150.

30.

Smereczyński A, Kołaczyk K. Pitfalls in ultrasound imaging of the stomach and the intestines. J Ultrason 2018; 18 (74): 207-211.

31.

Wüstner M, Radzina M, Calliada F, Cantisani V, Havre RF, Jenderka KV, et al. Professional Standards in Medical Ultrasound – EFSUMB Position Paper (Long Version) – General Aspects. Ultraschall Med 2022; 43 (5): e36-e48

Abstract

Ultrasound is a routine diagnostic procedure widely used in gastroenterology departments worldwide, and gastrointestinal ultrasound (GIUS) has become increasingly important in diagnosing and following gastrointestinal disorders. Being a real-time imaging modality, it has some advantages over static imaging modalities such as CT and MRI, and it allows the examiner to perform various techniques and methods to enhance visualisation. GIUS requires more than essential ultrasound experience, and acquiring good images for correct interpretation can be challenging even for the experienced examiner. As such, there are several pitfalls that clinicians should be aware of. Based on our clinical experience with an evidence-based approach, we present the ten most common mistakes made in gastrointestinal ultrasound and how to avoid them.

Topics

Radiology & Imaging

Citation

Gjengstø AJ, Nylund K, von Volkmann HL and Gilja OH. Mistakes in gastrointestinal ultrasound and how to avoid them. UEG Education 2023; 23: 27-32.

Published

2023

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Mistakes in coeliac disease diagnosis and how to avoid them

Roberto De Giorgio 1, Giacomo Caio 1, Umberto Volta 1

Affiliations

1 University of Bologna, Italy

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References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Nylund K, Maconi G, Hollerweger A, Ripolles T, Pallotta N, Higginson A, et al. EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound. Ultraschall Med 2017; 38 (3):273-284.

Nielsen MB, Cantisani V, Sidhu PS, Badea R, Batko T, Carlsen J, et al. The Use of Handheld Ultrasound Devices – An EFSUMB Position Paper. Ultraschall Med 2019;40(1):30-39.

Pinto PN, Chojniak R, Cohen MP, Yu LS, Queiroz- Andrade M, Bitencourt AG. Comparison of three types of preparations for abdominal sonography. J Clin Ultrasound 2011; 39 (4): 203-208.

Sinan T, Leven H, Sheikh M. Is fasting a necessary preparation for abdominal ultrasound? BMC Med Imaging 2003; 3(1):1.

10.

11.

12.

Nylund K, Hausken T, Gilja OH. Ultrasound and inflammatory bowel disease. Ultrasound Q 2010; 26 (1): 3-15.

13.

14.

Neye H, Voderholzer W, Rickes S, Weber J, Wermke W, Lochs H. Evaluation of criteria for the activity of Crohn's disease by power Doppler sonography. Dig Dis 2004; 22 (1): 67-72.

15.

16.

Limberg B. [Diagnosis of chronic inflammatory bowel disease by ultrasonography]. Z Gastroenterol 1999; 37 (6): 495-508.

17.

18.

19.

20.

21.

22.

23.

24.

Saevik F, Eriksen R, Eide GE, Gilja OH, Nylund K. Development and Validation of a Simple Ultrasound Activity Score for Crohn's Disease. J Crohns Colitis 2021; 15 (1): 115-124. 25.

25.

26.

Kucharzik T, Wittig BM, Helwig U, Borner N, Rossler A, Rath S, et al. Use of Intestinal Ultrasound to Monitor Crohn's Disease Activity. Clin Gastroenterol Hepatol 2017; 15 (4): 535-542 e2.

27.

28.

Di Mizio R, Maconi G, Romano S, D'Amario F, Bianchi Porro G, Grassi R. Small bowel Crohn disease: sonographic features. Abdom Imaging 2004; 29 (1): 23-35.

29.

30.

Smereczyński A, Kołaczyk K. Pitfalls in ultrasound imaging of the stomach and the intestines. J Ultrason 2018; 18 (74): 207-211.

31.

Abstract

Coeliac disease is an autoimmune disorder triggered by gluten, which activates an immune reaction against the autoantigen tissue transglutaminase (TG2) in genetically predisposed subjects. Genetic susceptibility to coeliac disease has been proven by its close linkage with major histocompatibility complex (MHC) class II human leukocyte antigen (HLA) DQ2 and DQ8 haplotypes. The identification of biomarkers for coeliac disease (e.g. endomysial antibodies [EmA] and antibodies to TG2 [anti-TG2]) has changed the epidemiology of coeliac disease from being a rare to a frequent condition, with an expected prevalence of 1% in the worldwide population. Coeliac disease can be difficult to diagnose because symptoms vary from patient to patient, and the majority of patients who have coeliac disease remain undiagnosed. Small intestinal biopsy remains the gold standard for coeliac disease diagnosis, and a delayed diagnosis in the elderly can be considered a risk factor for complications. Complicated coeliac disease is not so frequent, but for those who have it, the prognosis is very poor, with a low rate of survival after 5 years.

Topics

Small Intestine & Nutrition

Published

2024

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Mistakes in inflammatory bowel disease and reproduction and how to avoid them

C. Janneke van der Woude, Shannon Kanis

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References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Nylund K, Maconi G, Hollerweger A, Ripolles T, Pallotta N, Higginson A, et al. EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound. Ultraschall Med 2017; 38 (3):273-284.

Nielsen MB, Cantisani V, Sidhu PS, Badea R, Batko T, Carlsen J, et al. The Use of Handheld Ultrasound Devices – An EFSUMB Position Paper. Ultraschall Med 2019;40(1):30-39.

Pinto PN, Chojniak R, Cohen MP, Yu LS, Queiroz- Andrade M, Bitencourt AG. Comparison of three types of preparations for abdominal sonography. J Clin Ultrasound 2011; 39 (4): 203-208.

Sinan T, Leven H, Sheikh M. Is fasting a necessary preparation for abdominal ultrasound? BMC Med Imaging 2003; 3(1):1.

10.

11.

12.

Nylund K, Hausken T, Gilja OH. Ultrasound and inflammatory bowel disease. Ultrasound Q 2010; 26 (1): 3-15.

13.

14.

Neye H, Voderholzer W, Rickes S, Weber J, Wermke W, Lochs H. Evaluation of criteria for the activity of Crohn's disease by power Doppler sonography. Dig Dis 2004; 22 (1): 67-72.

15.

16.

Limberg B. [Diagnosis of chronic inflammatory bowel disease by ultrasonography]. Z Gastroenterol 1999; 37 (6): 495-508.

17.

18.

19.

20.

21.

22.

23.

24.

Saevik F, Eriksen R, Eide GE, Gilja OH, Nylund K. Development and Validation of a Simple Ultrasound Activity Score for Crohn's Disease. J Crohns Colitis 2021; 15 (1): 115-124. 25.

25.

26.

Kucharzik T, Wittig BM, Helwig U, Borner N, Rossler A, Rath S, et al. Use of Intestinal Ultrasound to Monitor Crohn's Disease Activity. Clin Gastroenterol Hepatol 2017; 15 (4): 535-542 e2.

27.

28.

Di Mizio R, Maconi G, Romano S, D'Amario F, Bianchi Porro G, Grassi R. Small bowel Crohn disease: sonographic features. Abdom Imaging 2004; 29 (1): 23-35.

29.

30.

Smereczyński A, Kołaczyk K. Pitfalls in ultrasound imaging of the stomach and the intestines. J Ultrason 2018; 18 (74): 207-211.

31.

Abstract

Inflammatory bowel disease (IBD) is a chronic relapsing gastrointestinal disease, often affecting young people during their fertile years. The chronic character of IBD means that lifelong medical treatment is often required. As such, it is not surprising that questions often arise about fertility and pregnancy in patients with IBD. The most important risk factor for adverse pregnancy outcomes in IBD patients is the presence of disease activity during pregnancy. Indeed, negative pregnancy outcomes (e.g. spontaneous abortion, preterm delivery and low birth weight) are associated with disease activity at the time of conception and during pregnancy.

Topics

IBD Primary Care

Citation

Cite this article as: Kanis SL and van der Woude CJ. Mistakes in inflammatory bowel disease and reproduction and how to avoid them. UEG Education 2016: 16: 20–23.

Published

2024

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Mistakes in liver transplantation and how to avoid them

Alberto Zanetto, Patrizia Burra

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References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Nylund K, Maconi G, Hollerweger A, Ripolles T, Pallotta N, Higginson A, et al. EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound. Ultraschall Med 2017; 38 (3):273-284.

Nielsen MB, Cantisani V, Sidhu PS, Badea R, Batko T, Carlsen J, et al. The Use of Handheld Ultrasound Devices – An EFSUMB Position Paper. Ultraschall Med 2019;40(1):30-39.

Pinto PN, Chojniak R, Cohen MP, Yu LS, Queiroz- Andrade M, Bitencourt AG. Comparison of three types of preparations for abdominal sonography. J Clin Ultrasound 2011; 39 (4): 203-208.

Sinan T, Leven H, Sheikh M. Is fasting a necessary preparation for abdominal ultrasound? BMC Med Imaging 2003; 3(1):1.

10.

11.

12.

Nylund K, Hausken T, Gilja OH. Ultrasound and inflammatory bowel disease. Ultrasound Q 2010; 26 (1): 3-15.

13.

14.

Neye H, Voderholzer W, Rickes S, Weber J, Wermke W, Lochs H. Evaluation of criteria for the activity of Crohn's disease by power Doppler sonography. Dig Dis 2004; 22 (1): 67-72.

15.

16.

Limberg B. [Diagnosis of chronic inflammatory bowel disease by ultrasonography]. Z Gastroenterol 1999; 37 (6): 495-508.

17.

18.

19.

20.

21.

22.

23.

24.

Saevik F, Eriksen R, Eide GE, Gilja OH, Nylund K. Development and Validation of a Simple Ultrasound Activity Score for Crohn's Disease. J Crohns Colitis 2021; 15 (1): 115-124. 25.

25.

26.

Kucharzik T, Wittig BM, Helwig U, Borner N, Rossler A, Rath S, et al. Use of Intestinal Ultrasound to Monitor Crohn's Disease Activity. Clin Gastroenterol Hepatol 2017; 15 (4): 535-542 e2.

27.

28.

Di Mizio R, Maconi G, Romano S, D'Amario F, Bianchi Porro G, Grassi R. Small bowel Crohn disease: sonographic features. Abdom Imaging 2004; 29 (1): 23-35.

29.

30.

Smereczyński A, Kołaczyk K. Pitfalls in ultrasound imaging of the stomach and the intestines. J Ultrason 2018; 18 (74): 207-211.

31.

Abstract

Topics

Hepatobiliary Surgery

Citation

Burra P and Zanetto A. Mistakes in liver transplantation and how to avoid them. UEG Education 2020; 2020: 1–6.

Published

2020

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Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Nylund K, Maconi G, Hollerweger A, Ripolles T, Pallotta N, Higginson A, et al. EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound. Ultraschall Med 2017; 38 (3):273-284.

Nielsen MB, Cantisani V, Sidhu PS, Badea R, Batko T, Carlsen J, et al. The Use of Handheld Ultrasound Devices – An EFSUMB Position Paper. Ultraschall Med 2019;40(1):30-39.

Pinto PN, Chojniak R, Cohen MP, Yu LS, Queiroz- Andrade M, Bitencourt AG. Comparison of three types of preparations for abdominal sonography. J Clin Ultrasound 2011; 39 (4): 203-208.

Sinan T, Leven H, Sheikh M. Is fasting a necessary preparation for abdominal ultrasound? BMC Med Imaging 2003; 3(1):1.

10.

11.

12.

Nylund K, Hausken T, Gilja OH. Ultrasound and inflammatory bowel disease. Ultrasound Q 2010; 26 (1): 3-15.

13.

14.

Neye H, Voderholzer W, Rickes S, Weber J, Wermke W, Lochs H. Evaluation of criteria for the activity of Crohn's disease by power Doppler sonography. Dig Dis 2004; 22 (1): 67-72.

15.

16.

Limberg B. [Diagnosis of chronic inflammatory bowel disease by ultrasonography]. Z Gastroenterol 1999; 37 (6): 495-508.

17.

18.

19.

20.

21.

22.

23.

24.

Saevik F, Eriksen R, Eide GE, Gilja OH, Nylund K. Development and Validation of a Simple Ultrasound Activity Score for Crohn's Disease. J Crohns Colitis 2021; 15 (1): 115-124. 25.

25.

26.

Kucharzik T, Wittig BM, Helwig U, Borner N, Rossler A, Rath S, et al. Use of Intestinal Ultrasound to Monitor Crohn's Disease Activity. Clin Gastroenterol Hepatol 2017; 15 (4): 535-542 e2.

27.

28.

Di Mizio R, Maconi G, Romano S, D'Amario F, Bianchi Porro G, Grassi R. Small bowel Crohn disease: sonographic features. Abdom Imaging 2004; 29 (1): 23-35.

29.

30.

Smereczyński A, Kołaczyk K. Pitfalls in ultrasound imaging of the stomach and the intestines. J Ultrason 2018; 18 (74): 207-211.

31.

Abstract

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a subclassification of steatotic liver disease (SLD), defined as the presence of excess triglyceride storage in the liver in conjunction with at least one cardiometabolic risk factor and no other discernible cause.1 Cirrhosis secondary to MASH is the most common cause of liver disease in the world and is the fastest-growing indication for liver transplantation, but it also has a >50% recurrence rate post-transplantation.

Topics

Hepatobiliary

Citation

Townsend SA and Newsome PN. Mistakes in nonalcoholic fatty liver disease and how to avoid them. UEG Education 2017; 17: 39–41.

Published

2024

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Abstract

Topics

Endoscopy

Published

2026

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C. Janneke van der Woude

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