To investigate the diagnostic value of ultrasound image-guided extracorporeal gastrointestinal multifunctional instrument based on pattern classification algorithm (PCA) on the physical status of patients after esophagectomy for esophageal cancer (EC), in this study, 120 esophageal cancer patients who entered our hospital for consultation and treatment from July 2019 to July 2020 were selected as the investigation subjects, and the patients were randomly divided into a control group (gastrointestinal motility drug treatment) and an observation group (gastrointestinal motility drug + extracorporeal gastrointestinal multifunctional apparatus (EGMA) therapy), with 60 cases in each group. A pattern classification method algorithm was designed for the ultrasound image characteristics of esophageal cancer tumors and applied to the clinical identification and diagnosis of postoperative status of esophageal cancer patients by the ultrasound image-guided extracorporeal gastrointestinal multifunctional instrument. The results showed that the time of exhaustion, the time of recovery of bowel sounds, and the time of the beginning of gastrointestinal peristalsis in the observation group were better than those in the control group, and the difference between the two groups was statistically significant ( P < 0.05 ); the incidence of postoperative abdominal distension in the observation group was 15%, and that in the control group was 28.3%; the incidence of postoperative abdominal distension in the observation group was significantly lower than that in the control group, and the difference was statistically significant ( P < 0.05 ). In conclusion, the use of EGMA guided by ultrasound image based on PCA can effectively improve the gastrointestinal function of esophageal cancer patients and significantly reduce the incidence of postoperative complications, which is worthy of clinical promotion.