Is there intestinal dehiscence?

The fat around the small intestine is hyperechoic ( focal peritonitis after surgery) and the is ileus present in the large intestines

A challenging one but I will take a crack at it. I see a moderately dilated loop of small intestine with some echogenic liquid digesta. I think I can see the suture line as the bowel is followed caudally and the digesta flows freely through this region to the other side. There is some localized free fluid in the region and some gas reverberation which is suspicious for peritonitis but it is not severe and I would expect some gas pockets from laparotomy. I also think the fat should be more inflamed with dehiscence. The fluid would be a challenge to tap. The pancreas is hypoechoic and the surrounding fat is hyperechoic with trace effusion. I would be more suspicious of post-op pancreatitis than dehiscence in this case.

Hi. It looks like a duodenum because it is adjacent to the pancreas. Duodenum presents liquid content and increased peristalsis. Adjacent to the mesenteric wall and in the mesenteric wall, hyperechoic stitches are seen. Which can be gas bubbles and stitches respectively. You do not see free fluid but a slight peritoneal reaction.
I'm not sure if there is dehicencia. I would recommend ultrasound control in 24 hours.

hyerechoic sorrounding fat suggesting peritonitis , and a small amount of free fluid , the pancreas seems hypoechoic, and also some luminal hyperechoic content in the mucosa wall i think its positive for ulcer or deshiscence. and reactive pancreatitis or peritonitis.

i think that close to the wall of the small intestine you have a hiperechoic reaction with focal peritonitis, and the wall of duodenum has lost the normal architecture. There is also ileus.

Actually, this should read duodenectomy! Sorry for the error...the surgical site was circumferential.