RESUMO
Ultrasound has a well-established role in the detection of intra-abdominal pathology except for those conditions affecting the hollow visceral organs. This paper examines the role of real-time ultrasonography in a prospective study involving 25 patients with suspected large and small bowel masses and compares the sensitivity, specificity and accuracy of the technique with the double contrast barium examination and operative findings. In the 20 cases where direct comparison between ultrasound and surgery was possible, the data were concordant in 16 (80 per cent) cases and discordant in 4 (20 per cent) cases. Ultrasound was falsely negative and falsely positive in 2 cases, each, respectively. Ultrasound had a detection sensitivity of 90 per cent, specificity of 72 per cent and accuracy of 84 per cent. Discordant data were obtained in 6 cases between barium and ultrasound and in 4 cases between barium and surgery. Ultrasound allowed accurate separation from mesenteric, retroperitoneal, pelvic and other intra-abdominal masses but was less precise in differentiating bowel masses arising from the caecum and terminal ileum, and between the pelvic colon and distal small bowel loops. Additional features of ultrasound are the ability to attempt a prediction of benignity or malignancy of masses and to assess for ascites, metastases or lymphadenopathy. In those situations, therefore, where a mass of the hollow abdominal viscera is suspected and where double contrast barium studies are not possible, the use of real-time ultrasonography is advocated as a useful alternate approach (AU)
