G.I. or Pancreas? The Clinical Sonographer's Perspective of the Abdominal Puzzle

Gastrointestinal disease and pancreatic pathology frequently present with nearly identical clinical signs, creating a diagnostic puzzle for the clinician and sonographer alike. This lecture examines how ultrasound can help differentiate between primary gastrointestinal disease and pancreatic pathology by evaluating organ appearance, surrounding tissue response, and patient pain responses during scanning. Lecture attendees will review the normal and abnormal sonographic appearance of the stomach, intestines, and pancreas, while learning how subtle clues such as Murphy sign/splinting, regional pain localization, inflammatory “fluffy” mesenteric fat, and enlarged mesenteric lymph nodes, can help narrow the differential diagnosis. Emphasis is placed on understanding which pathology may be primary and which may be reactive, allowing clinicians to better interpret imaging findings within the context of the patient’s clinical presentation. Practical clinical approaches to treatment and management of both gastrointestinal and pancreatic disease will also be discussed.

• What is sonographically normal and abnormal in the gastrointestinal tract?
• Differentiate gastrointestinal and pancreatic disease using clinical signs and key sonographic features.
• Interpret findings such as pain localization, inflammatory fat, and mesenteric lymphadenopathy to determine the likely primary disease process.
• Apply imaging findings to guide appropriate clinical treatment strategies for pancreatic versus gastrointestinal disease.