Ultrasound as First Line Step in Anaemia Diagnostics

Abstract

This review covers the role of ultrasonography as an essential non-invasive diagnostic approach when facing patients with anemia, a common clinical problem. Abdomen ultrasound is well recognized as a first-line examination in the setting of blood loss, both acute and chronic. Less is clear about the additional opportunities, given by ultrasound in anemia, due to the many other possible causes.
 Here we provide information on the utility of ultrasound in different contexts and a practical guide for clinicians facing anemic patients

Anemia as a Problem: GP Approach

“…In the primary care settings, ultrasound (US) of the abdomen as an essential noninvasive diagnostic approach can detect possible alterations such as abdominal masses that can address the possible etiology of detected anemia. The US findings of the liver, spleen, bowel, stomach, and gynecologic or lymph node alterations can guide further investigation in patients with anemia [28]. However, the role of abdominal US in evaluation of anemia is inferior to endoscopic examination including upper and lower gastrointestinal endoscopy.…”

“…According to Focused Assessment with Sonography for Trauma (FAST), rapid detection of free fluid can be suggestive for hemoperitoneum, hemothorax, and/or hemopericardium in patients with anemia due to acute blood loss [28]. The use of FAST has been reported to decrease the abdominal CT use by approximately 50% [28, 29].…”

“…According to Focused Assessment with Sonography for Trauma (FAST), rapid detection of free fluid can be suggestive for hemoperitoneum, hemothorax, and/or hemopericardium in patients with anemia due to acute blood loss [28]. The use of FAST has been reported to decrease the abdominal CT use by approximately 50% [28, 29]. The early detection of bleeding in nontraumatic cases is based on sonographic markers of hypovolemia including the diameter of the inferior cava vein and the thickness of the left ventricle [28].…”

“…The use of FAST has been reported to decrease the abdominal CT use by approximately 50% [28, 29]. The early detection of bleeding in nontraumatic cases is based on sonographic markers of hypovolemia including the diameter of the inferior cava vein and the thickness of the left ventricle [28].…”

“…Namely, the European Crohn’s and Colitis Organization (ECCO) guidelines highlighted ultrasonography as the imaging technique of choice for screening IBD patients [30]. While ultrasonographic signs of thickening, decreased compressibility, and increased vascularization of the bowel wall can be detected in IBD, “pseudo-kidney sign” (hypoechoic bowel wall thickening and irregular contour, loss of stratification of the wall layers, and the absence of normal peristalsis) can be suggestive of CRC [28, 31]. Detection of liver lesions suggesting metastasis can indicate presence of malignancy [28, 31].…”