The accuracy and usefulness of gastrointestinal ultrasound (GIUS) for detecting activity and complications of inflammatory bowel diseases (IBD), has been reported in studies, promoting this technique as an important tool for the management of IBD patients. Whilst well recognised by international guidelines, standardization and general agreement in the definition of the luminal and extra-intestinal features, still need to be well defined.A task force group of 17 experts in GIUS faced this issue, by developing recommendations and clinical guidelines for the use of GIUS in IBD, under the auspices of EFSUMB. This article presents the consensus on the current data on sonographic features of IBD and summarises the accuracy of different sonographic modalities for the management of IBD patients.

In October 2014 the European Federation of Societies for Ultrasound in Medicine and Biology formed a Gastrointestinal Ultrasound (GIUS) task force group to promote the use of GIUS in a clinical setting. One of the main objectives of the task force group was to develop clinical recommendations and guidelines for the use of GIUS under the auspices of EFSUMB. The first part, gives an overview of the examination techniques for GIUS recommended by experts in the field. It also presents the current evidence for the interpretation of normal sonoanatomical and physiological features as examined with different ultrasound modalities.

In many clinical conditions, high-resolution sonography and color (power) Doppler sonography can be used as the first-line modality for evaluating cervical soft tissue masses. Cervical cysts, lipomas, paragangliomas, neurogenic tumors, hemangiomas, and lymphangiomas often exhibit characteristic sonographic appearances. Sonography can be used for lymph node assessment, and most salivary gland diseases can be diagnosed sonographically. Sonography can be used to guide needle biopsy of soft tissue neoplasms and lymph nodes. In addition, the relationship between a cervical mass and the great vessels can be evaluated.

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The outer appendiceal diameter of 6 mm or more as a sign of acute appendicitis provides high sensitivity but limited specificity. This diagnostic criterion is more useful in excluding acute appendicitis than in confirming it.

There are several US signs associated with adult celiac disease. None of the signs identified is specific, but a combination of signs is characteristic and indicates suspicion of this disease in a high percentage of cases. US could help to avoid diagnostic delay, especially in patients who have atypical clinical presentations.

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Acute bowel inflammation frequently originates from thin-walled diverticula of the colon. Not the presence of diverticula, but the demonstration of an inflamed diverticulum, is diagnostic of diverticulitis in cases of bowel wall thickening and pericolic inflammation. The aim of this study was to investigate the sonographic appearance and detectability of inflamed diverticula. One hundred seventy-five consecutive patients with clinically suspected diverticulitis underwent sonographic examination. Outpouchings from the colonic wall centred in the pericolic inflammation were considered inflamed diverticula. Depending on the sonographic appearance they were divided into four groups: hypoechoic; predominantly hyperechoic; hyperechoic with surrounding hypoechoic rim; and hyperechoic with acoustic shadowing. Sonography showed inflamed diverticula in 79 (77%) of 102 patients with diverticulitis. Inflamed diverticula were hypoechoic in 37%, predominantly hyperechoic in 4%, hyperechoic with surrounding hypoechoic rim in 41% and hyperechoic with acoustic shadowing in 18% of patients. In 23 (23%) of 102 patients no inflamed diverticulum was demonstrable. This group included 17 patients with complicated diverticulitis and 6 false-negative cases. An inflamed diverticulum as a sign of diverticulitis yielded an overall sensitivity of 77% and a specificity of 99%. Sensitivity in uncomplicated disease was 96%. In patients with uncomplicated diverticulitis an inflamed diverticulum is a sign of diverticulitis with excellent sensitivity and specificity, usually with solitary and less frequently with more than one inflamed diverticulum being demonstrable. In patients with complicated diverticulitis an inflamed diverticulum is often not detectable.