Ultrasound has emerged as a valuable tool for the diagnosis of select conditions in the emergency department. It is noninvasive and inexpensive, and should be readily available to the emergency department physician. Improvements in transducer technology have greatly improved ultrasound imaging. Ultrasound is somewhat operator dependent, and the images are difficult to interpret in obese patients or patients with large amounts of intestinal air or gas. Air is a poor conductor of ultrasound because it scatters, refracts, and reflects the sound waves. Fluid-filled structures transmit sound exceedingly well, and since most of the soft tissues are composed of varing amounts of water, ultrasound is feasible throughout the GI tract and pelvis. A full bladder is an acoustic window into the pelvis, and the liver helps transmit ultrasound in the right upper quandrant.
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