Bowel Diseases

Synonyms/Description

Pelvic masses related to bowel such as appendicitis, endometriosis, colon cancer, Crohn’s disease, ulcerative colitis, diverticulitis, lymphoma, sarcoma, or other bowel-specific diseases identified on a pelvic ultrasound

Etiology

There are multiple etiologies in this grouping of bowel diseases. The etiologies range from inflammatory/infectious such as appendicitis, inflammatory bowel diseases, and diverticulitis to neoplasms such as lymphomas, carcinomas, and sarcomas.

In the small bowel, neuroendocrine tumors, adenocarcinomas, sarcomas, lymphomas, and miscellaneous tumors comprise 36.5%, 30.9%, 10.0%, 18.7%, and 3.9% of malignancies, respectively. In the appendix, neuroendocrine tumors, adenocarcinomas, sarcomas, lymphomas, and miscellaneous tumors comprise 31.7%, 65.4%, greater than 1%, 1.7%, and 1.1% of malignancies, respectively. Colon tumors include mostly adenocarcinomas (93.0%), whereas sarcomas and lymphomas are relatively rare.

These entities are briefly discussed in terms of ultrasound findings because they may be encountered during a sonographic gynecologic exam. For more detailed information about any of these lesions, please refer to the suggested reading.

Ultrasound Findings

Diseases of the bowel are detectable and can be accurately diagnosed using ultrasound. Typically the sonographic evaluation of bowel abnormalities includes the appearance of the bowel wall, amount and quality of peristalsis, reaction to manual compression using the transducer, and relative “stiffness” of the bowel loop. Also there may be a nonspecific mass, which is difficult to distinguish from adnexal or uterine masses. It is crucial to identify the uterus and ovaries separate from the mass to correctly diagnose it as a bowel problem.