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Showing posts with label USG Intestine. Show all posts
Showing posts with label USG Intestine. Show all posts

Case 121: Appendicular Abscess || Ultrasound

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Clinical Features:

11-year-old female patient came with severe right lower abdominal pain.


Ultrasound Features:

- Right iliac fossa shows an irregular thick-walled complex collection with internal low-level echoes.

- Vermiform appendix is not separately visualized.

- Surrounding thickened fat layer is seen.

- Adjacent bowel loops show sluggish movements.

- Color Doppler shows prominent perilesional vascularity.

- The lesion compresses adjacent psoas muscle with no intrapsoas abnormality at present.

- Adjacent multiple prominent lymph nodes are seen.


Remember:

Peritoneal collection adjacent to a gangrenous appendix or abscess may suggest perforation.


Ultrasound Diagnosis:

Appendicular Abscess 


Ultrasound Images:







Appendicular abscess


YouTube Link:

For further demonstration, don't forget to check our video:

YouTube Link










Case 109: Midline Epigastric Hernia || Ultrasound

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Clinical Features:

A 40-year-old female came with occasional epigastric swelling.


Ultrasound Features:

- A herniated sac is noted at the midline epigastric region.

- Content appears to be reducible omental fat.


Remember:

Color Doppler may help exclude strangulation in an obstructed hernia.


Ultrasound Diagnosis:

Midline Epigastric Reducible Hernia


Ultrasound Images:





A herniated sac is noted at the midline epigastric region having reducible omental fat as content


YouTube Link:

For further demonstration, don't forget to check our video:

YouTube Link








Case 64: Acute Appendicitis || Ultrasound

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Clinical Features:

An 11-year-old male patient came with severe right lower abdominal pain.


Ultrasound Features:

A blind-ended, distended, non-compressible, tubular structure of intestinal origin, connected to adjacent caecum with the presence of gut signature, surrounding fat stranding & mild perilesional collection is noted at the right iliac fossa.


Ultrasound Diagnosis:

Acute appendicitis.


Remember:

Loss of gut signature suggests gangrenous change. Whereas, localized collection adjacent to a gangrenous appendix may suggest perforation.


YouTube Link:


YouTube


Ultrasound Images:










Case 56: Intestinal Ascariasis || Ultrasound

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Clinical Features:

A 7-year-old boy came with

- Lower abdominal cramping pain

- Frequency of micturition


Ultrasound Features:

Multiple tubular echogenic motile structures are noted within the small intestinal lumen adjacent to the urinary bladder.


Remember:

In endemic as well as non-endemic areas, if a regular abdominal ultrasound of a child complaining about abdominal pain shows no definite organic abnormality then do not end the examination without searching for intestinal worms.


Ultrasound Images:



Fig: Multiple tubular echogenic motile worms within the small intestinal lumen.


YouTube Video Link:


https://youtu.be/FMLRzOiYuG8




Case 55: Morgagni Hernia || Congenital Diaphragmatic Hernia || Ultrasound

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Clinical Features:

A 1.5 years old child came with recurrent episodes of respiratory distress.


Ultrasound Features:

A gap is seen at the anteromedial aspect of the right dome of the diaphragm through which the intestinal loops with peristalsis & internal dirty shadow casting echogenic air are herniating to the right lower chest.


Remember:

When you get an uncommon lesion on an x-ray or on any other imaging modality that can be seen on ultrasound, check that with ultrasound.


Ultrasound Images:


Fig: Lt: Normal spleen & left hemidiaphragm. Rt: Part of liver with a defect of diaphragm at the medial aspect causing herniation of intestinal loops to the right lower chest.


Fig: Part of liver with a defect of diaphragm at the medial aspect causing herniation of intestinal loops to the right lower chest.


Fig: Right lower chest showing gas-filled bowel loops casting dirty shadows.


Fig: Chest X-ray; bowel loops are seen at right lower chest.


Fig: Barium meal x-ray; small bowel loops are seen at right lower chest.



YouTube Video Link:

https://youtu.be/2uQT_8r6lDI








Case 48: Acute Appendicitis || Ultrasound

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Clinical Features:

A middle-aged male patient came with severe right lower abdominal pain.


Ultrasound Features:

A blind-ended, distended, non-compressible, tubular structure of intestinal origin, connected to adjacent caecum with the presence of gut signature & surrounding echogenic thick fat layer is noted at the right iliac fossa.


Remember:

Localized collection adjacent to an inflamed appendix should be assessed carefully by magnifying the field of view to exclude perforation.


Ultrasound Images:


Fig: Inflammed vermiform appendix


Fig: Inflammed vermiform appendix; Diameter: 10mm


Fig: Inflammed vermiform appendix

YouTube Video Link:


https://youtu.be/YTt6hLVZiN0

Case 39: Intestinal Ascariasis || Ultrasound

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Clinical Features:

A 20 years old female patient came with central abdominal cramping pain.


Ultrasound Features:

Multiple tubular echogenic motile structures are noted within the small intestinal lumen.


Remember:

In endemic as well as non-endemic areas, if a regular abdominal ultrasound of a child complaining about abdominal pain shows no definite organic abnormality then do not end the examination without searching for intestinal worms.


Ultrasound Images:






Fig: Multiple tubular echogenic motile worms within the small intestinal lumen.





YouTube Video Link:



https://youtu.be/ojdDy0y9Gj8




Case 30: Appendicular Perforation

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Appendicular Perforation


Common in recurrent appendicitis.


Case 01:


Patient with severe right lower abdominal pain for 2-3 days with history of recurrent appendicitis. 
Mildly distended appendix with loss of gut signature due to gangrenous change with a small gap on the appendicular wall with communicating small hazy collection and surrounding thick echogenic fat accumulation.

Case 06: Intestinal Helminthiasis Ultrasound

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Introduction:

Intestinal worms can be visualized with high frequency transducer in suspected cases.

Clinical Features:

9 years old female patient came with the history of
1. Periumbilical pain.
2. Anorexia.


Ultrasound Findings:

Two tubular shaped lumen containing structures are noted with in the transverse colon forming typical target sign.

Images:



Features Suggestive Of:

Intestinal Ascariasis