OBJECTIVE: To evaluate whether abdominal ultrasound correctly diagnosed septic peritonitis and correctly identified its causative lesion in dogs and cats.
METHODS: 84 client-owned dogs and 10 cats that underwent an abdominal ultrasound and had confirmation of septic peritonitis via exploratory laparotomy or necropsy.
METHODS: This retrospective case series documented abdominal ultrasound findings, surgical or necropsy findings, and method for initial diagnosis of septic peritonitis, if different from surgery or necropsy. The surgical report and necropsy findings were compared to sonography results to confirm a diagnosis of septic peritonitis. The frequency at which sonography diagnosed septic peritonitis and its causative lesion was calculated for each type of lesion pathology and organ system. Secondary aims included evaluating the effect of patient characteristics (body weight and species) on sonographic results and whether lesion type or location affected mortality.
RESULTS: Most lesions causing septic peritonitis (70.2%) were gastrointestinal in origin and were nonneoplastic ulcerations or perforations (50%). Abdominal ultrasound diagnosed 56.3% of cases of subsequently confirmed septic peritonitis and correctly identified 67% of the causative lesions. Lesions of the gastrointestinal tract and ulcerations/perforations were the most frequent correct sonographic diagnoses and most likely to lead to a correct sonographic diagnosis of septic peritonitis. Lesions located in the hepatobiliary system and lesion types other than neoplasia or ulcerations/perforations were the most frequently missed by abdominal ultrasound.
CONCLUSIONS: Abdominal ultrasound often fails to diagnose septic peritonitis or the underlying causative lesion, and its accuracy depends on the affected organ and type of lesion.

OBJECTIVE: Ultrasound plays a central role in liver transplant evaluation. Acute, subacute, and chronic complications can be readily identified using grayscale and color Doppler ultrasound. Contrast-enhanced ultrasound adds a new dimension to liver transplant evaluation, depicting vascular and parenchymal processes with exquisite detail. In addition, emerging evidence suggests that contrast-enhanced ultrasound may allow for localization of biliary leak in select patients. We aimed to assess the use of multiparametric ultrasound-including grayscale, color and spectral Doppler, and contrast-enhanced ultrasound-in the setting of liver transplantation.
METHODS: A literature review was performed using the MEDLINE bibliographic database through the National Library of Medicine. The following terms were searched and relevant citations assessed: \"abdominal ultrasound,\" \"contrast-enhanced ultrasound,\" \"liver transplant,\" and \"ultrasound.\"
RESULTS: Grayscale and color Doppler ultrasound represent the mainstay imaging modalities for postoperative liver transplant evaluation. The addition of contrast enhancement plays a complementary role and can provide valuable information related to the allograft vasculature, parenchyma, and biliary tree. The appropriate implementation of grayscale, color Doppler, and contrast-enhanced ultrasound can optimize sensitivity, specificity, and accuracy for the detection of liver transplantation complications, including hepatic artery stenosis, biliary leakage, and infection.
CONCLUSIONS: Multimodal sonographic evaluation is essential to identify postoperative complications in liver transplant recipients. Contrast-enhanced ultrasound may be of value in challenging cases, providing excellent anatomic delineation and reducing the risk of false-positive and false-negative diagnoses. A broad familiarity with appropriate applications of both nonenhanced and contrast-enhanced ultrasound may help radiologists optimize allograft assessment and improve patient outcomes.

UNASSIGNED: Trans-abdominal ultrasound (TAUS) and transvaginal ultrasound (TVUS) are used for embryo transfer. However, few studies were conducted to compare the methods and assess their effect on pregnancy outcomes.
UNASSIGNED: A retrospective cohort study was conducted at Mahdieh Hospital in Tehran, analyzing 506 ICSI cycles with fresh embryo transfer. The study period was from April 2019 to March 2022. Following the evaluation of patients\' profile, they were divided into two groups of TAUS (n=250) and TVUS (n=256). The pregnancy outcomes included positive test of β-HCG, history of miscarriage, ectopic pregnancy (EP), clinical pregnancy, and the duration of the embryo transfer were compared between two groups. Mann-Whitney U test, Pearson Chi-Square test, Fisher\'s exact test, and logistic regression were used for data analysis.
UNASSIGNED: The rate of chemical and clinical pregnancy in the TAUS group was higher compared to the TVUS group, which was statistically significant (p<0.05). The rate of live term birth and live preterm birth was higher in the TAUS group compared to the TVUS group, though the difference was insignificant. Moreover, EP and abortion rates were higher in TVUS group compared to the TAUS group, but the differences were not statistically significant. The odds ratio of achieving pregnancy was higher with TAUS compared to TVUS, but this was only statistically significant for the age variable.
UNASSIGNED: The use of TAUS method appears to be associated with improved pregnancy outcome, including higher rates of chemical and clinical pregnancy, compared to TVUS. Yet, further research is needed to confirm these findings and elucidate underlying mechanisms.

Intraductal papillary neoplasm of the bile ducts is a rare tumor. Characteristic features include bile duct dilatation, cystic lesions with communication to the bile ducts, and intraluminal solid nodules arising from the bile duct wall. As in pancreatic intraductal papillary mucinous neoplasia, intestinal, pancreaticobiliary, gastric, and oncocytic types are described. Intraductal papillary neoplasm of the bile ducts has a high potential for malignancy, and patients should be surgically resected when possible. In this review, the complex imaging diagnosis is presented. The main focus is on contrast-enhanced ultrasound, an established method for many other indications whose potential on the biliary system should be better exploited. In the present article, typical contrast-enhanced ultrasound findings in intraductal papillary neoplasm of the bile ducts are demonstrated.

Objectives-The objective was to compare the effectiveness of observation in standard-of-care computed tomography (CT) in adult patients with suspected acute appendicitis (AA). Methods-Patients with clinically suspected AA and inconclusive diagnosis after primary clinical examination, laboratory examination, and transabdominal ultrasound (TUS) were eligible for the study, and they were randomized (1:1) to parallel groups: observation-group patients were observed for 8-12 h and then, repeated clinical and laboratory examinations and TUS were performed; CT group (control group) patients underwent abdominopelvic CT scan. The study utilized Statistical Analysis System 9.2 for data analysis, including tests, logistic regression, ROC analysis, and significance evaluation. Patients were enrolled in the study at Vilnius University Hospital Santaros Klinikos in Lithuania between December 2018 and June 2021. Results-A total of 160 patients (59 men, 101 women), with a mean age of 33.7 ± 14.71, were included, with 80 patients in each group. Observation resulted in a reduced likelihood of a CT scan compared with the CT group (36.3% vs. 100% p < 0.05). One diagnostic laparoscopy was performed in the observation group; there were no cases of negative appendectomy (NA) in the CT group. Both conditional CT and observation pathways resulted in high sensitivity and specificity (97.7% and 94.6% vs. 96.7% and 95.8%). Conclusions-Observation including the repeated evaluation of laboratory results and TUS significantly reduces the number of CT scans without increasing NA numbers or the number of complicated cases.

Artificial intelligence (AI) applications are used in gastroenterology for automatic imaging diagnostic methods such as ultrasonography, computer tomography, magnetic resonance imaging, but also in endoscopy, capsule endoscopy and biopsy followed by automatic digital pathology evaluation. The accuracy of AI-based systems is superior to human expertise. Furthermore, in reality, a very small percentage of the patients are being investigated by a human expert in endoscopy, so implementing AI in this investigation would only increase the diagnostic accuracy. The existence of an unimaginable number of digital images and different types of medical information made possible the analysis and training of convolutional neural network (CNN), which consists of multilayers of artificial neural networks (ANN) with step-by-step minimal processing, creating a fundamental resource for any AI-based system to learn by itself how to automatically perform medical tasks, which were performed only by human experts in the past. The main objectives for AI applications used in gastroenterology are to improve the medical procedures with enhanced precision, to reduce the number of medical errors and to perform repetitive tasks.

Postoperative intussusception (POI) after abdominal and non-abdominal operations is a rare but recognized condition discussed several times in literature. There are scarce reports regarding POI in children operated primarily for intussusception. We discuss three such cases that were seen in our institution in the last two years. The patients showed symptoms of atypical ileus that failed to resolve two to eight days following primary surgery. Ultrasound reported intussusception and surgical intervention was sought. All patients had ileoileal intussusception. Manual reduction was successful in two cases. One had intestinal necrosis and underwent resection and anastomosis. Recovery was satisfactory without recurrence. POI should be suspected in patients who show signs of intestinal obstruction in early postoperative period. A second POI should be kept in mind after surgical reduction of the first intussusception. Ultrasound should be performed to aid diagnosis followed by urgent surgical intervention.

Pregnancy-associated gastric cancer is extremely rare. In many cases, the cancer is already advanced at the time of diagnosis, and the prognosis is often poor. A 39-year-old primigravida, with dichorionic diamniotic twins, was admitted to our hospital for threatened preterm labor at 31 weeks of gestation. At 32 weeks of gestation, she developed a fever and tested positive for influenza A. She recovered from influenza A on the following day but had an emergency cesarean section for premature rupture of the membranes at 32 weeks of gestation. She was discharged on postpartum day six. Thereafter, she was again infected with influenza A. On day 18, she underwent an abdominal ultrasound revealing multiple mass lesions in the liver, because she had an uncomfortable upper gastric with persistent fever. She was referred to the internal medicine team, who made a diagnosis of stage IV gastric cancer. Importantly, non-specific symptoms and physical signs that are not explicable by the normal course of pregnancy may be recognized through conscientious history-taking and physical observations. If gastrointestinal symptoms are prolonged, or if symptoms such as severe weight loss, melena, a tender abdominal mass, or persistent and unexplained fever develop, an endoscopic assessment should be conducted to suspect other diseases. In addition, proactive ultrasound scanning, including the upper abdomen, may detect pregnancy-associated gastric cancer and lead to further in-depth investigations.

The use of ultrasound while caring for critically ill patients has been increasing exponentially in the last two decades and now is an essential component of intensive care practice. Abdominal ultrasound is an established technique in other specialties, but its use in intensive care has lagged behind other ultrasound modalities. However, its potential role in the diagnosis and management of patients will make it an invaluable tool for intensivists. The main use of abdominal ultrasound at the bedside is for free fluid detection in trauma patients. But abdominal ultrasound can also help us diagnose patients with abdominal pain, hypovolemia or anuria, and it can guide us during procedures such as paracentesis or bladder catheter and gastric tube placement.

Phenylbutazone (PBZ) is a widely used nonsteroidal anti-inflammatory drug for horses. However, because of its gastrointestinal side effects, its administration requires careful attention in veterinary practice. Malondialdehyde (MDA) is a serum biomarker associated with increased damage to the equine gastrointestinal system. This study investigated the hematological effects and alterations in the gastrointestinal tract and assessed serum MDA concentrations following repeated oral PBZ administration at clinical doses. Fourteen horses were randomly divided into control and treatment groups. All horses in the treatment group were administered 4.4 milligrams per kilogram of body weight of PBZ syrup orally twice a day for 7 days, whereas the control group received syrup as a placebo. The development of gastrointestinal side effects was investigated using gastroscopy, abdominal ultrasound, and fecal pH; serum MDA concentrations were assessed using a commercially available enzyme-linked immunosorbent assay kit. Data were compared between PBZ-treated and control horses before and after the treatment period. The treatment group exhibited decreased albumin and total protein concentrations. Moreover, this group exhibited a higher thickness of the right dorsal colon wall (p = 0.03) and had higher scores for squamous gastric ulcers (p = 0.01). Fecal pH was lower in the treatment group than in the control group after PBZ administration (p < 0.01). Although MDA concentrations were higher in the treatment group after PBZ administration, they did not differ significantly from those of the control group. This study highlighted the changes in hematological and gastrointestinal lesions resulting from PBZ administration in horses at clinical doses, even without clinical signs. However, MDA may not be an optimal biomarker for the early detection of gastrointestinal damage due to PBZ treatment in horses.