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Transabdominal gastrointestinal ultrasound (GIUS) is unique in its capacity to examine the bowel non-invasively and in its physiological condition, including extra-intestinal features such as the splanchnic vessels, mesentery, omentum and lymph nodes- even at the bedside. Despite this, and its extensive documentation for its usefulness, it has only been fully implemented in a few European countries and expert centres. Therefore, the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) established a GIUS Task Force Group in 2014 consisting of international experts from 9 European countries with the objectives to standardize and promote the use of GIUS in a clinical setting. This is achieved by publishing clinical guidelines and recommendations on indications and use of GIUS and so far,4 guidelines have been published: first on "examination techniques and normal findings", second on "inflammatory bowel disease", third on "acute appendicitis and diverticulitis" and fourth on "transrectal and perineal ultrasound".This paper describes the ultrasound features of miscellaneous disorders such as celiac disease, cystic fibrosis, omental infarction, Meckel's diverticle, endometriosis, intestinal neoplasia, mucocele, amyloidosis, GVHD, foreign bodies, vasculitis, and pneumatosis cystoides intestinalis. Bowel ultrasound can be indicated in most of these conditions to investigate intestinal symptoms but in other cases the alterations of the bowel can be also an incidental finding that suggest other examinations which finally help to discover an unknown pathological condition.

An interdisciplinary task force of European experts summarizes the value of gastrointestinal ultrasound (GIUS) in the management of acute appendicitis and diverticulitis. Based on an extensive literature review, clinical recommendations for these highly common diseases in visceral medicine are presented.In patients with acute appendicitis, preoperative sonography has been established as a routine procedure in most European countries for medical and legal reasons. Routine sonography in these patients may reduce the rate of unnecessary surgery by half. The sensitivity, specificity, and accuracy of ultrasound reach values above 90 % and are equivalent to CT and MRI. However, the high operator dependence may be a problem, for example in point-of-care ultrasound in emergency departments. Structured training programs, quality controls and standardized ultrasound reporting should be increasingly implemented.In the case of suspected acute diverticulitis, "ultrasound first" should also be a basic element in the approach to all patients. Sonography can confirm the diagnosis and allows early risk stratification. As treatment strategies have become less aggressive and more tailored to the stage of diverticulitis, accurate staging has become increasingly important. GIUS and CT have proven to have similar sensitivity and specificity. Especially in cases of uncomplicated diverticulitis, GIUS will be the one and only imaging procedure. CT may work as a backup and has particular advantages for diverticulitis located in the distal sigmoid, inflammation deep in the small pelvis and insufficient ultrasound scanning conditions. This step-up approach (ultrasound first and CT only in case of a negative or inconclusive ultrasound result) has proven to yield the best accuracy., Competing Interests: Speaker honoraria, Pentax Medical Singapore LtdConsulting/Advisory board, Mediglobe Corporation GmbhCongress participation support, Hitachi Medical Systems UKSpeaker honoraria, Abbvie, Janssen, TakedaSpeaker honoraria, Bracco, Hitachi, GE, Mindray, Supersonic, Pentax, Olympus, Fuji,Boston Scientific, AbbVie, Falk Foundation, Novartis, Roche; AdvisoryBoard Member, Hitachi, Mindray, Siemens; Research grant, GEMindray, SuperSonicSpeaker honoraria, AbbVie, Bracco, Almirall, GE Healthcare, Takeda AS, Meda AS, Ferring AS, AllegaConsultant fee Bracco, GE Healthcare, Takeda and SamsungSpeaker honoraria, Abbvie, Falk Foundation, Ferring, Janssen-Cilag, MSD, Pfizer, Takeda;Advisory Board/Consultant fee: Abbvie, Celgene, Janssen-Cilag, MSD, TakedaSpeaker honoraria, Abbvie, Alfa Sigma, Janssen-Cilag; Advisory Board/Consultant fee, Allergan, Novartis, Takeda, THDSpeaker honoraria, Falk Foundation; Research grant, GE HealthcareSpeaker honoraria, Meda AS, Ferring pharmaceuticals, TakedaSpeaker honoraria, Philips, GE, Canon; Advisory Board Member, Siemens; Congress participation support, SiemensSpeaker honoraria Bracco, Toshiba. Advisory board member Bracco. Education support Philips. Technical consultancy Philips, BK The following members declared no conflicts of interest: Klaus Dirks, Trygve Hausken, Antony Higginson, Alois Holleweger, Nadia Palotta, Tomás Ripollés, Laura Romanini, Carla Serra, (© Georg Thieme Verlag KG Stuttgart · New York.)