29. Instrumental methods of examination of the alimentary tract — abdominal ultrasound, gastroscopy.colonoscopy, rectoscopy, liver biopsy, CT scanning, MR] - diagnostic abilities of the methods
Covers the main instrumental methods for examining the alimentary tract: abdominal ultrasound, gastroscopy, colonoscopy, rectoscopy, liver biopsy, CT and MRI. For each method it sets out what the procedure does and which conditions it can diagnose. A closing table compares the methods by whether they are invasive, their best uses and their limitations.
Topic 28 of 30 in the MU Sofia syllabus for Internal Medicine (Practical) (Medicine, Year 3). The free AceMed note covers it in 9 sections, about 245 words (2 min of reading), with 13 flashcards.
In this note
Instrumental Methods of Examination of the Alimentary Tract
I. Abdominal Ultrasound
II. Gastroscopy (Upper GI Endoscopy)
III. Colonoscopy
IV. Rectoscopy / Proctoscopy
V. Liver Biopsy
VI. Computed Tomography (CT Scan)
VII. Magnetic Resonance Imaging (MRI)
VIII. Comparison Summary
I. Abdominal Ultrasound
➤ What it does:
Uses sound waves to image abdominal organs.
First-line, non-invasive method.
➤ Diagnostic Uses:
Liver: Fatty liver, cirrhosis, masses, bile duct dilation
Gallbladder: Stones, cholecystitis
Pancreas: Tumors, inflammation, pseudocysts (limited by gas)
Intestine: Thickening in IBD (limited)
Free fluid: Ascites detection
II. Gastroscopy (Upper GI Endoscopy)
➤ What it does:
Visualization of esophagus, stomach, duodenum using a flexible endoscope.
➤ Diagnostic Abilities:
Detects:
Gastritis
Peptic ulcers
Esophageal varices
Hiatal hernia
Tumors
H. pylori biopsy sampling
Can stop bleeding (therapeutic)
III. Colonoscopy
➤ What it does:
Visualization of entire colon and distal terminal ileum.
Allows biopsy and polypectomy.
➤ Diagnostic Abilities:
Colorectal cancer screening
Inflammatory bowel disease (Crohn’s, UC)
Colon polyps
Diverticulosis
Lower GI bleeding source
IV. Rectoscopy / Proctoscopy
➤ What it does:
Visualization of anal canal and rectum
Often performed in outpatient clinics.
➤ Diagnostic Abilities:
Hemorrhoids
Anal fissures
Rectal tumors or polyps
Rectal bleeding
V. Liver Biopsy
➤ What it does:
Invasive procedure to obtain liver tissue for histological analysis.
➤ Diagnostic Abilities:
Evaluate:
Fibrosis/cirrhosis
Hepatitis (viral, autoimmune, drug-induced)
Wilson disease, hemochromatosis
Liver tumors (if unclear by imaging)
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