Abdominal examinations are now made much simpler with the use of ultrasound. The entire abdominal-thorack regions can be checked, and growths, cysts and similar abnormalities quickly picked up. The ultrasound depends on harmless sounds and waves bouncing through the organs making irregular patterns if unusual pathological objects are present.
Computerised tomography (the CT scanner) is also widely used, “whole body” pictures being taken. It is possible to take slices through any part of the body, or at any angle, to obtain the diagnosis. This has revolutionised diagnosis and, in turn, treatment. It makes early accurate diagnosis much simpler. The MRI (magnetic resonance imaging) machine similarly is able to give very precise pictures of the body’s internal organs and specific parts. Newer techniques are continually being developed and rapidly put into everyday use, despite their enormously high cost to install and operate.
A recent advance is PET, short for positron emission tomography. This is claimed to give even better and clearer images, and is an invaluable aid in early and accurate diagnosis of disease. The investigations that will be ordered in any particular case will depend on the physician, the facilities available and the hospital where he or she works. Although the high-tech methods attract the greatest attention, and everybody wants to be first with the latest, many of the older routine methods are still used, and offer assistance in diagnosis.
Also, in recent years, the hepatic scintiscan has been developed. Briefly, this picks up abnormalities of the liver, filling defects, cysts, tumours and cancers, and is a valuable diagnostic tool. It is commonly referred to as a simple liver scan. Radioactive material (usually colloidal gold or 99 Tc [technetium]) is injected, and this is readily taken up by the liver cells. A subsequent scan gives a picture indicating filling defects if present. It materially assists accurate diagnosis of disease that may not be readily detected by other means.
It is also possible to detect disease by radiological means. Oesophageal varices that occur as a result of liver disease may be detected by a barium swallow X-ray. The blood vessels may be X-rayed by other techniques called portal venography and coeliac angiography. This gives a clear outline of the blood vessels and may indicate the presence of certain disease processes. The fibre-optic endoscope is probably the most accurate diagnostic instrument.
Another widely used diagnostic method is the needle biopsy of the liver. When the diagnosis is in doubt, a needle is pushed through the skin into the liver, and cells are removed and examined by the pathologist. Often this gives firsthand information that again can pinpoint an accurate diagnosis.
Many of these newer forms of diagnostic tests are a major advance on the other methods that have been in use for many years. But many of the older methods offer valuable information and are still widely utilised.