How to prepare for an ultrasound of the hepatobiliary system. Diet before ultrasound examination

Ultrasound scanning of the hepatobiliary sphere is the most common radiological examination method. So frequent use associated with accessibility, simplicity of the procedure and at the same time diagnostic accuracy, non-invasiveness, and safety. Since when ultrasound scanning Ionizing radiation is not used; it is used in children and pregnant women.

Ultrasound of organs abdominal cavity

Indications for ultrasound of the hepatobiliary system

Pain syndrome in the abdomen.
Suspicion of biliary colic.
Jaundice.
Enlargement of the abdominal organs, detected by palpation.
Suspicion of a tumor in the abdomen.
A history of pathology of the hepatobiliary system.
Portal hypertension, etc.

Ultrasound technique

Ultrasound is performed according to standard methods. The duration of this study is on average twenty to thirty minutes. To improve visualization of organs, the doctor may ask the patient to hold their breath for deep breath, turn over on your side. Sometimes, when individual characteristics Patients, for example, if the spleen is located very high in the abdominal cavity, have to be scanned while sitting or even standing.

Patient in left lateral position

In the process of liver echography, the position, size, shape of the organ being studied, its echogenicity, structure, and pathological formations are assessed. The condition of the bile ducts and blood flow are studied (both in the organ and in the identified lesion).

When examining the gallbladder, the thickness of the wall of the organ is measured, attention is paid to the nature of the bile, foreign inclusions in the lumen (calculi). The size of the common bile duct (common bile duct) and the ultrasound signal of the contents are assessed.

At ultrasound examination of the pancreas, they study the size and shape of the organ, evaluate the homogeneity of the structure and echogenicity of the parenchyma, the presence of zones of altered ultrasound signal, the condition excretory duct glands.

When scanning the spleen, in addition to standard parameters, the portal, inferior vena cava and splenic veins are studied.

After the procedure, a protocol with an ultrasound report is issued.

Based on the scan results, the doctor ultrasound diagnostics does not diagnose! The diagnosis is made by the attending physician (taking into account clinical picture, data from instrumental, laboratory and radiation methods examinations).

How to prepare for research

Ultrasound of organs digestive system carried out on an empty stomach

An ultrasound scan of the hepatobiliary system requires special training, on which the quality and information content of the study depends. The point is that the passage ultrasonic wave air and fat interfere, therefore, in order to properly prepare for an ultrasound, you need to remove the excess air contained in the intestines. This is especially important for obese patients.

The exception is emergency pathology; in these cases, preparation for the study is not carried out.

Basic principles of preparation for ultrasound

Follow a slag-free diet for at least three days before the proposed examination, and also exclude foods that cause gas formation: vegetables, fruits, carbonated drinks, juices, rye bread.
The last meal before the study should be ten to twelve hours (that is, the technique is performed on an empty stomach).
If the patient has increased gas formation, then two days before the procedure you must use carminatives(for example, Espumisan for adults and children over six years old, recommended dosage: two to three capsules after meals and at night; on the day of the ultrasound examination, this drug does not need to be taken).

Ultrasound of the abdominal cavity in children

IN Lately There has been a persistent increase in diseases of the hepatobiliary system in childhood, which is due to a lot of reasons. For early detection this pathology in children and adequate differential diagnosis of tumor formations require a modern, non-invasive, safe and available method visualization, such as ultrasound echography.

Ultrasound should be performed at the first symptoms of diseases of the digestive system in children. At the same time, the research methodology and preparation for the procedure in children are the same as in adults. Often visualization internal organs in children it is better due to less fatty tissue.

I would like to note that ultrasonic method is very important in the diagnosis of diseases of the digestive system, both in adults and children.

Do not forget that before a planned examination, careful preparation of the patient for the examination is necessary.

For pain in the right side or under the ribs, an ultrasound of the hepatobiliary system is required. Our body has an important system that produces and excretes bile and is called the hepatobiliary system. Hepato means liver, and bile is called biliary. Bile is formed in the liver and is secreted through: the gallbladder with intrahepatic, extrahepatic ducts through which bile exits.

What does the liver do in this system?

The liver produces bile and thanks to it the body can digest food. Bile is always produced and goes into the gallbladder. When food needs to be digested, it goes into the duodenum. In addition, thanks to bile, fats and vitamins are absorbed.

If any of these organs gets sick, immunity drops, metabolism slows down, and detoxification is possible. After all, they are neutralized in the liver harmful substances, entered into our body with food and water. Medicines are also digested in it.

"Advice: The load on the liver is heavy. Modern people They eat a lot of fatty, smoked, fried, salty, spicy, canned foods and exercise little. Refuse such food - it greatly harms the organ."

Such an ultrasound, where bile-forming and bile-excreting organs are prescribed in such cases:

When a child complains starting from the 1st grade of school. when his diet changes, physical activity increases emotional load. Teenagers are actively growing, their hormonal levels are changing. If your son or daughter has pain in the right side, nausea is felt. increased fatigue - make an appointment with a doctor;
If you or your child feels after running or walking sharp pain in the right side, you feel bad after shaking in transport, eating fried, smoked and other junk food- this is a reason to see a doctor. There may be stones in the bile ducts. If it is large, it will block several of them - this is life-threatening. When you move in jerks, the stones can move;
How do liver disorders appear externally? People around you will notice that you have an acetone smell coming from your breath, the whites of your eyes and skin will turn yellowish, you will feel nauseous, and there will be a swelling on your stomach. venous mesh, and venous stars will appear throughout the body, fluid will accumulate in the peritoneum;
You will feel pain in the right hypochondrium, and in the morning there will be bitterness in your mouth with nausea;
If you have undergone surgery or been injured, monitor your condition and consult a doctor in a timely manner.

The results are deciphered by a doctor.

Why is the hepatobiliary system affected?

The liver is aggressively affected by toxins with poisons, viruses with bacteria and free radicals. Metabolic events may occur in the hepatobiliary system hormonal disorders. This happens due to poor nutrition, reception harmful drugs without medical supervision, for those who often drink alcohol. Negatively on nervous system and the entire body is affected by stress, provoking the development of pathologies in the internal organs.

Ultrasound

When performing an ultrasound of the organs of the hepatobiliary system, the doctor examines the organs located in the peritoneum, the liver and ducts. You need to prepare in the same way as for examining other internal organs - stick to a diet for several days, follow other doctor’s recommendations.

This is what the gastrointestinal tract looks like on ultrasound:

Here's how to prepare for an ultrasound:

Cleanse the intestines. This is done so that the food and gases in it do not interfere with showing the ultrasound specialist what condition the organ is in. 2 days before the examination you are not allowed to: legumes, soda, raw vegetables and fruits, sweets with cabbage. If you can, give yourself a cleansing enema;

When there is 1 day left before the examination, chew your food well and eat smaller portions. Let the last dinner be a maximum of 2 hours before going to bed;
2 days before the ultrasound, try to drink no more than 2.5 liters per day.

Now you know how to prepare for the examination procedure. With an ultrasound, the doctor will assess the shape of the liver, the size of its ducts, and how they and other organs are located in the peritoneum. The doctor will examine the entire space for neoplasms, assess the size of the walls and blood flow if they do an ultrasound with Doppler ultrasound.

The doctor carefully examines everything in the peritoneum to see if there are any abscesses, wounds or other pathologies. The examination results will be interpreted by the doctor.

With ultrasound diagnostics, a specialist can detect the following diseases:

Hepatitis or acute or chronic inflammation in the liver. A person gets hepatitis due to viruses. There are 5 types of the disease: A with B, C with D and E. These are different infections. Signs of hepatitis: the liver enlarges, the tissue changes in structure, the blood vessels also suffer;
With cirrhosis, the corners of the liver widen and become rounded. The structure of the organ tissues is lumpy. In cirrhosis, it may accumulate excess liquid in the peritoneum, the spleen will enlarge;
Cholecystitis is an inflammation of the walls of the gallbladder. In inflamed areas, echogenicity is increased, the Wirsung duct is dilated;
Dyskinesia in the biliary tract. This occurs in children and adolescents up to about 14 years of age;
Stones are also found in the bile ducts. They are perfectly visualized on ultrasound. The doctor will assess how many there are, how they are located and how large they are;
There may be neoplasms in the internal organs. Often inside the liver. They are filled with blood or bile, air, pus;
Hepatomegaly.

"Advice. If you come to the doctor with complaints of pain in the right side, then, in addition to an ultrasound, ask the doctor for a referral for a blood test with liver biochemistry. MRI with CT, biopsy with PCR diagnostics, and other types of examination will not be superfluous.”

If you have problems with this system. then you need to fix it normal nutrition, excluding harmful products. Try to keep your diet balanced. A person needs a certain amount of proteins with fats, carbohydrates, vitamins and microelements per day.

Now for some time you can’t eat fried, smoked, spicy or salty foods; forget about canned fish and other chemicals for a while. Take a choleretic drug with hepatoprotectors. Add fiber-rich vegetables and fruits to your diet. In addition, after reading the article, you know how to prepare for ultrasound examinations of internal organs and will prepare for the procedure in 2 days.

Hepatobiliary - under such a long name hides one of the most important systems our body, which is responsible for the formation and excretion of bile. The first part of the word hepato is translated as liver. Biliar is bile. Thus, when speaking about the hepatobiliary system, we mean the liver itself, as the organ in which bile is formed, as well as the excretory system - the gallbladder, intrahepatic and extrahepatic bile ducts.

Functions of the liver and hepatobiliary system

The main function of the liver is to produce bile, which helps digest food. The production of bile occurs continuously, it enters the gallbladder, and from it, during digestion, it enters the duodenum. Bile is responsible not only for the digestion of food, but also for the absorption of vitamins and fats. Any damage or malfunction of organs leads to disturbances in metabolism, antimicrobial protection, and work immune system, possible detoxification of the body (after all, it is in the liver that all harmful substances that enter the body are “neutralized”).

For metabolism medicines the liver also responds.

It bears a huge load, but at the same time it is able to recover - this is true unique organ. But, despite the ability of the liver to recover, it still suffers due to bad habits, poor nutrition, unfavorable environmental situation, features sedentary lifestyle life of a modern person.

Indications for ultrasound examination of bile-forming and bile-excreting organs:

Any complaints about organ dysfunction in infants and children adolescence. IN early age complaints may be associated with the beginning of school, when the child’s psycho-emotional and physical stress, diet and diet change. Adolescent children experience a change hormonal levels, there is a phase active growth body. The child may complain about increased fatigue, abdominal discomfort, nausea, pain in the right side. Biliary dyskinesia is often detected in children;
Complaints of sharp pain in the abdominal area after walking, running or even riding in public transport, as well as after eating too fatty, smoked and fried foods. Complaints can be provoked by stones in the bile ducts, which are displaced by sudden movements;
Appearance external signs liver dysfunction: bad breath (resembling the smell of acetone), a yellow tint to the sclera and skin, a bright venous pattern on the abdomen, accumulation of fluid in the abdominal cavity, impaired skin pigmentation and the appearance of spider veins;
Pain in the right hypochondrium, girdle pain, regular bitterness in the mouth (especially after sleep), nausea;
Control after injuries, mechanical damage, surgical intervention.

Traditionally, one of the most rapid, accurate and affordable research methods is ultrasound. Ultrasound of organs can reveal a large number of diseases. Most often, ultrasound of the liver and ducts is carried out as part of a general ultrasound examination of the abdominal organs, therefore the preparation requirements are similar to the requirements for preparation for ultrasound of internal organs.

Before conducting the study you must:

Cleanse the intestines so that accumulated food and gases do not interfere. To do this, 2-3 days before the ultrasound it is necessary to exclude foods from the diet causing gas formation: carbonated drinks, legumes, black bread, raw vegetables and fruits, cabbage, sweets, etc. A few hours before the procedure, you can drink Espumisan (see the instructions for dosage). Also, in some cases, a cleansing enema is recommended;
The day before the ultrasound, it is recommended to eat small meals, with the last meal no less than 2 hours before bedtime;
Limit the amount of liquid consumed.

During the examination, the doctor evaluates the shape, size and position of the organs, the space around them, the presence of tumors, the size of the walls, structure and blood flow (if ultrasound is performed with Doppler ultrasound), inflammatory changes, etc.

The most common diseases of the system and their ultrasound diagnostics:

Hepatitis is a liver disease inflammatory in nature, can be acute or chronic. Hepatitis has viral nature and are divided into 5 types: A, B, C, D, E, depending on the types of infection. Hepatitis is determined by the following signs, clearly visible on ultrasound: Enlarged liver, changes in vascular pattern and tissue structure;
Cirrhosis is characterized by widening of the angles of the organ, rounding of its edges, and a change in structure to tuberous. Also, with cirrhosis, the spleen enlarges and can accumulate free liquid in a stomach;
Cholecystitis (inflammation of the gallbladder wall) appears on ultrasound as a thickening of the organ wall in the presence of echogenic fields and inclusions;
Pancreatitis (gallbladder disease) is characterized by increased echogenicity in the foci and dilation of the Wirsung duct;
Biliary dyskinesia (especially in children in early and teenage years);
Stones in the biliary tract are usually clearly visible on ultrasound, even at the stage of formation. The doctor evaluates the size, number and position of the stones;
Neoplasms of internal organs, most often inside the liver itself, which, depending on the type, can be filled with fluid, blood, pus or air;
Hepatomegaly.

Along with prescribing and conducting an ultrasound examination, a patient with complaints must undergo a series of additional procedures: blood test, liver biochemistry; if necessary, CT, MRI, PCR diagnostics, biopsy, etc.

For patients with identified systems, it is important to follow the basics proper nutrition: ensure a balance of proteins, fats and carbohydrates; limit intake of fried, smoked and spicy food, and also regularly take hepatoprotectors and choleretic drugs. It is also encouraged to consume foods with high content fiber.

The hepatobiliary system is a complex multi-level mechanism that allows such critical processes, such as digestion and excretion (removal of metabolic products from the body). The result of its damage is a violation metabolic processes, detoxification processes, as well as immune response and antimicrobial defense.

The hepatobiliary system consists of the gallbladder, liver and bile ducts. Its main task is the formation and transportation of bile, which is produced by liver cells. It moves through the ducts to the gallbladder, which is an additional reservoir. The bile that accumulates in it is 5-10 times more concentrated than the liver bile. After eating, it enters the lumen of the duodenum. The anatomy of the hepatobiliary system, in addition to the liver and gallbladder, includes intrahepatic systems that are located directly in the liver. They, starting as bile capillaries, gradually become larger bile ducts that extend beyond the liver. The extrahepatic bile ducts are represented by the common hepatic and common cystic ducts, which, when connected, form the common bile duct.

Bile, its functions in the body

The functions of bile, which contains electrolytes dissolved in water, heavy metals(copper) and organic matter(bile salts and acids, cholesterol, bilirubin and many others) are very diverse. First of all, it is involved in and also enhances the hydrolysis and absorption of proteins and carbohydrates. Bile is a catalyst for the activity of intestinal and pancreatic enzymes, thereby stimulating the process of digestion and absorption of fats and vitamins A, D, E, K.

In addition to the secretory function, bile in the body also plays a regulatory role, controlling bile formation and bile excretion, influencing motor and secretory functions small intestine. It is involved in the inactivation of peptin and of hydrochloric acid, included in gastric juice, stimulates proliferation (growth) and desquamation epithelial cells intestines, affects mucus secretion. In addition, it is involved in the neutralization of various toxic and medicinal substances.

Liver

The anatomy of the hepatobiliary system considers the liver not only as the central organ of bile formation, but also as most important organ person. It is here that most of the body’s energy is formed, because 20% of the mass of the cells that make up the liver is occupied by mitochondria that synthesize ATP. The liver is the largest gland in the human body, which ensures the continuity internal environment body. It plays a central role in protein, fat and carbon metabolism, as well as in the metabolism of medicinal substances. The liver is one of the few organs that are constantly exposed to severe stress, but at the same time are capable of self-recovery. short time. In the body it performs the following functions:

bile formation and bile excretion;
metabolic - in addition to the fact that the synthesis of many substances (proteins, cholesterol, glycogen, urea) necessary for normal operation The gastrointestinal tract, in the liver, regulates water metabolism and the exchange of amino acids and proteins, carbohydrates, fats and biologically active substances;
storage - the liver is a kind of storeroom where proteins, carbohydrates, fats, vitamins, hormones, and minerals accumulate;
barrier - here foreign and toxic compounds that enter the body with food or formed in the intestines are neutralized;
excretory - the liver is able to remove what enters it toxic substances into bile, which, due to its composition, removes them from the body;
homeostatic - synthesis, accumulation and breakdown of blood plasma components, in particular immunoglobulins and components of the coagulation system, occur in the liver.

Causes of damage to the hepatobiliary system

Dysfunction of the hepatobiliary system, in particular the liver, most often results from the action of aggressive compounds. These include exposure to poisons, bacterial and viral lesions, free radicals. Also, the hepatobiliary system may suffer due to various hormonal and metabolic disorders, poor quality nutrition, uncontrolled use of medications, alcohol abuse. Stress can also play an important role in the occurrence of various pathologies.

Types of lesions of the hepatobiliary system

Modern medicine highlights the following types defeats, causing disturbance hepatobiliary system:

Mitochondrial - these lesions develop at the cellular level and consist of partial blockade of enzymes. Most often they are the result of the use of antibiotics (tetracyclines), antiretroviral drugs, parenteral nutrition. Manifestations of such lesions include fibrosis, and sometimes proliferation of the bile ducts is possible.
Protein dystrophy occurs due to impaired protein synthesis. Most often, such lesions are the result of long-term toxic effects(alcohol, medicinal substances, viral and bacterial lesions, poisons).
Fibrosis develops due to medicinal lesions. Most often they are caused by cytotoxic drugs. It manifests itself as growth fibrous tissue, which, by disrupting blood flow, causes an increase in pressure in the portal vein and disrupts the functioning of liver cells.
Cholestasis is a decrease in the amount of bile entering the duodenum, or its absence. The reason for this may be a mechanical obstacle (stones in gallbladder) or disorders that occur at the level of liver cells and intrahepatic bile ducts.
Vascular lesions - may appear on different levels its circulatory network, starting from capillaries and ending with damage to the vessels of the arterial bed and system
Thickening of bile - this pathology of the hepatobiliary system most often develops due to mucous or bile plugs. Most often it occurs in newborns and is associated with a conflict regarding the Rh factor.

Symptoms

Diseases of the hepatobiliary system, as a rule, have specific and nonspecific symptoms. Nonspecific symptoms include intoxication symptoms, manifested by lethargy, fatigue, weakness and fever during periods of exacerbation of the disease. They are associated with a decrease in the detoxification function of the liver, possible reabsorption of bile or disturbances in protein, carbohydrate or vitamin metabolism. TO specific symptoms These include those manifestations that occur when the hepatobiliary system is directly affected. These include:

various digestive disorders (nausea, heaviness in the right hypochondrium, less often vomiting caused by food provocation, diarrhea);
abdominal pain “in the pit of the stomach” or localized on the right side, usually occurring after eating fatty or smoked foods;
skin manifestations ( spider veins, xanthomas, pigmentation disorders, jaundice);
ascites - accumulation of fluid in the abdominal cavity;
increased venous pattern on the abdomen;
presence of liver odor from the mouth.

Disorders of the hepatobiliary system in children

The hepatobiliary system in children is much less likely than in adults to undergo inflammatory processes caused by infectious factors. Much more often, its pathologies are associated with functional disorders. They can be diagnosed in children of different ages, but most often they affect schoolchildren. This is associated with an increase in mental, emotional and physical activity, as well as with changes in diet. Important in the occurrence functional disorders It has enhanced growth And hormonal changes the child's body. Dyskinesia is most often diagnosed during this period. biliary tract, less often - cholecystocholangitis and cholecystitis.

Despite the significant advances in modern hepatology, there is an increase in various lesions of the biliary tract and their tendency to become chronic and have a long, protracted course, therefore timely diagnosis becomes a top priority. In addition to examination, history taking and laboratory research, the most informative of which can be considered blood biochemistry, help determine following methods studies of the hepatobiliary system.

Computed tomography - more often performed to control the biopsy of tissues of the abdominal organs, it is most informative when intravenous administration contrast agents.
MRI - allows you to effectively identify various lesions liver tissue and cysts, allows you to examine and identify vascular changes during oncological processes.
Radionuclide scanning - allows you to evaluate bile excretion and various changes in liver tissues, identify tumor processes, foci of inflammation and assess the patency of the bile ducts.
Cholangiography can detect stones and tumors in bile ducts, as well as the presence of fistulas and other pathologies of the biliary tract. In addition, this examination allows you to take samples of bile and bile duct epithelium, as well as insert a catheter and drain bile, dilate the bile ducts and administer drugs that dissolve stones (gallstones).
Angiography assesses blood flow in the portal and hepatic veins. Is of decisive importance when differential diagnosis oncological lesions liver.
Ultrasound of the hepatobiliary system is the simplest, most accessible and informative method research. It allows you to identify stones in the gallbladder and bile ducts, optimal for identifying ascites.

Ultrasound of the hepatobiliary system

The preparation required to conduct this study is quite simple, but is necessary to obtain full picture. Its goal is to minimize the amount of gases in the intestines so that intestinal loops do not block the view of the organs being examined. To do this, on the eve of the examination you need to perform a cleansing enema or take a laxative. In order for the procedure to be as effective as possible, three days before it is necessary to follow a diet that reduces the process of gas formation. The examination should be carried out on an empty stomach, at least 8 hours must have passed since the last meal.

Diet before ultrasound examination

When performing an ultrasound of the hepatobiliary system, preparation must necessarily include, in addition to cleansing procedures, a diet that reduces gas formation. Here are its principles:

Meals should be small - at least four times a day, and the last meal should be at least 2 hours before bedtime.
The volume of liquid must be reduced to one and a half liters.
Eliminate from your diet foods that contain yeast, fatty meat or fish, legumes, sugar, strong tea or coffee, carbonated or alcoholic drinks.

The hepatobiliary system performs many essential functions in the human body, and timely identified violations in its work will help to avoid many problems in the future.

is a diagnostic method that is used to identify liver damage, diseases of the gallbladder and its ducts. Ultrasound is absolutely painless and has no contraindications, which is why it is prescribed to pregnant women and children from the moment of birth. The only condition is that to examine the hepatobiliary system using an ultrasound machine, special preparation is required for 3-4 days.

Ultrasound examination of the hepatobiliary zone is performed in all patients with the following symptoms:

pain in the right hypochondrium, worsening at night and in a state of hunger;
nausea and regular vomiting;
bloating, gas, diarrhea;
fragile blood vessels (nosebleeds and too heavy menstruation, endless bruises);
yellowing of the skin and sclera;
long-term use of strong medications;
alcohol abuse, poisoning with other poisons;
chronic diseases (cholecystitis, hepatitis, pancreatitis, etc.).

Preparation

Ultrasound of the hepatobiliary system is done externally, transabdominally.

Despite the apparent simplicity of ultrasound, preparation for it requires a lot thorough. It includes diet, reception special drugs and slight fasting.

Diet Before examining the liver and gallbladder, you need slag-free, as before an ultrasound of the abdominal cavity. Have to in 3-4 days before scanning exclude All gas-forming products.

What foods should you avoid?

White cabbage;
beans, peas;
fresh bakery;
raw vegetables and fruits;
prunes;
nuts.
strong black tea.
milk.
pasta.
sweets, chocolate, cream pastries.

What should be on the menu?

dishes from beef, chicken, rabbit, turkey;
steamed cutlets, meatballs;
casseroles and puddings;
low-fat cottage cheese;
steamed and boiled vegetables;
vegetable soups, purees;
boiled fish;
second-day bread and biscuits.

Do I need to take medications?

Usually, necessity in the use of medications No . However, if you are concerned "bloating" , active persitalsis or stool disorders you can use drugs with sorbent action :

Activated carbon;
white coal;
"Polysorb", etc.

Examination of the hepatobiliary system is done only on an empty stomach, the period without food is at least 8 hours.

It is best to go for an ultrasound in the morning without breakfast; diabetics are allowed a light breakfast. For example, a cup of tea with a slice of white bread.

In case of constipation, it is advisable to do a cleansing enema at night.

Children require special preparation. It's hard for the kids for a long time starve, so an exception is made for them. Children up to a year you don't have to feed in 2-3 hours before the procedure, 1-3 years – in 4 hours . kids older will already be able to hold out 5-6 hours . And here drink to kid it is forbidden give in an hour before ultrasound - regardless of age .

If your baby has gas or diarrhea before the procedure, you need to consult with your pediatrician about what medication to give your child. Under no circumstances should you choose your own medicine! When the opposite problem arises - constipation in the baby, an enema can be done on the eve of the ultrasound.

SELF-MEDICATION IS HARMFUL TO YOUR HEALTH
License of the Ministry of Health of the Republic of Crimea to carry out medical activities No. LO-82-01-000232 dated November 15, 2016