Sonographic Diagnosis of Symptomatic Palpable Gastrointestinal Masses in Emergency Department Patients

Gastrointestinal tract masses are usually evaluated by barium study of the gastrointestinal tract or endoscopy; ultrasonography has rarely been used because of gastrointestinal air. To describe the findings of performing ultrasound on patients presenting to the emergency department with palpable gastrointestinal masses. Retrospective study of patients presenting to the emergency department with palpable gastrointestinal masses between 2003 and 2005. Clinical and sonographic characteristics useful for differential analysis between neoplasm or lymphoma and intussusception were described. The authors found two ileocholic intussusception cases, two lymphoma cases, and four gastrointestinal tract neoplasm cases. The sonographic hallmark of the two cases of intussusception was seen as a "target" doughnut, or bull's eye sign. Two hypoechoic rings being separated by a hyperechoic ring or crescent in axial images are typically found. The subsequent immediate surgery confirmed the diagnosis. In the cases of lymphoma or carcinoma, the lesion presented as a hypoechoic mass with irregular margins and central linear echoes with typical "pseudokidney" aspect; the diagnoses were confirmed by surgery. In opposition to what is commonly believed of sonographic diagnosis of gastrointestinal masses is rapid and simple to perform. The examination could be conclusive, focus further diagnostic studies, and reduce the number of further examinations or hospitalizations. [PUBLICATION ABSTRACT]