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Bowel

(Top) Graphic shows the colon in situ. The transverse colon has been retracted upward to demonstrate the arterial supply of the colon from the superior and inferior mesenteric arteries. The SMA supplies the colon from the appendix through the splenic flexure, and the inferior mesenteric artery (IMA) supplies the descending colon through the rectum. Note the band of smooth muscle (taenia coli) running along the length of the intestine, which terminates in the vermiform appendix; these result in sacculations/haustrations along the colon, giving it a segmented appearance. (Bottom) Graphic shows the longitudinal section of a male pelvis. The anus is the external opening of the rectum and terminal end of the GI tract. The internal anal sphincter (IAS) is a thin involuntary muscle deep to the submucosa. The external anal sphincter is thicker, encircles the IAS, and is under voluntary control.

Bowel

(Top) Transverse oblique ultrasound at the epigastric region shows the gastroesophageal (GE) junction, which can be traced to the fundus of the stomach. Note the relationship to the adjacent structures. (Middle) Transverse oblique ultrasound through the left upper quadrant shows the collapsed stomach body with the rugal folds. Echogenic gas is seen between the rugae. The tail of the pancreas is seen posterior to the stomach, and the left lobe of the liver is anterior to the stomach. (Bottom) High-resolution transverse ultrasound through the epigastric region shows the gastric body tapering to the gastric antrum. Note the gastric folds (rugae). The stomach wall shows the gut signature.

Bowel

(Top) Transverse oblique ultrasound through the epigastric region shows the pylorus with the hypoechoic prominent muscular wall leading to the duodenal bulb. (Middle) Transverse ultrasound through the upper abdomen shows the gastric antrum anteriorly compressed by the curvilinear probe and collapsed 3rd part of the duodenum (D3) posteriorly. The SMA and the superior mesenteric vein (SMV) are seen in the plane in between. The inferior vena cava (IVC) and aorta are seen posterior to the D3. (Bottom) Axial midline high-resolution ultrasound through the upper abdomen shows fluid distended in the D3 located across, in the upper retroperitoneum. Note the aorta and IVC posterior to the D3. Gut signature is seen in the wall of the D3.

Bowel

SMALL BOWEL AND LARGE BOWEL

(Top) Transverse oblique ultrasound through the right iliac fossa (RIF) with graded compression shows a compressed, normal terminal ileum (between the abdominal wall musculature anteriorly and psoas muscle posteriorly) leading to the cecum. (Middle) Transverse high-resolution ultrasound through the RIF in the same patient shows the ileocecal junction and the ileocecal valve. (Bottom) Transverse ultrasound through the left iliac fossa (LIF) shows a short-axis view of the descending colon with gut signature. Medial to the descending colon, normal jejunal loops can be seen with valvulae conniventes.

Bowel

(Top) Left sagittal ultrasound shows the normal descending colon in a collapsed state and compressed by the ultrasound probe. Note the gut signature. This is an alternative appearance to the descending colon when it is collapsed and empty. (Middle) High-resolution left sagittal ultrasound obtained with a higher frequency linear probe from the same patient shows the collapsed descending colon with gut signature. The hypoechoic outer layer represents the muscularis propria layer. (Bottom) Transvaginal ultrasound shows the sigmoid colon and pelvic loops of small bowel. Note the hypertrophied outer muscularis propria layer of the sigmoid colon, seen in patients with irritable bowel syndrome and early diverticular disease.