Ultrasound

A Rare Cause of Pelvic Pain in a Teenage Girl

Amber Marie Hathcock, MD, MPH^*, Manish I Shah, MD, MS^*, Jennifer E Dietrich, MD, MSc^{^} and Esther M Sampayo, MD, MPH^*

DOI: https://doi.org/10.21980/J87D0WIssue 3:3 No ratings yet.

Due to pain out of proportion to her exam, an ultrasound of her pelvis was obtained and showed a blood-filled distended uterus, or hematometrocolpos (white arrow), with a 4.9 cm right ovarian cyst (blue arrow). A pelvic magnetic resonance imaging (MRI) then revealed an obstructed right hemi-vagina, normal left uterus and vagina and ipsilateral renal agenesis (red arrow) with normal left kidney (double arrow) consistent with obstructed hemivagina, ipsilateral renal agenesis (OHVIRA) syndrome. The patient underwent surgical repair with complete resolution of symptoms.

Ob/Gyn Visual EM

Right Ventricular Dilation in Patient With Submassive Pulmonary Embolism

Adrian Diez, MD^* and Christopher Bryczkowski, MD^*

DOI: https://doi.org/10.21980/J82P84Issue 3:3 No ratings yet.

Bedside echocardiography four chamber view revealed enlarged right ventricular (RV) to left ventricular (LV) ratio (greater than 1) on apical four-chamber view (see red and blue outlines respectively). The right atrium is not clearly delineated in this image and therefore is not outlined. One can also rule out a large pericardial effusion as the cause of her dyspnea, since there is no large hypoechoic collection surrounding the heart on either four- chamber view or parasternal long view.

Cardiology/Vascular Visual EM

Point of Care Ultrasound Illustrating Small Bowel Obstruction

Badriah Alruwaili, MBBS^* and Shadi Lahham, MD^*

DOI: https://doi.org/10.21980/J8T637Issue 3:3 No ratings yet.

POCUS of the small bowel illustrated significantly dilated loops of bowel (white line), thickened bowel wall (white arrow) and to-and-fro peristalsis, consistent with small bowel obstruction.

Abdominal/Gastroenterology Ultrasound Visual EM

Retinal Detachment

Adnan Riaz, MD^*, Chirag Shah, MD^* and Grant Wei, MD^*

DOI: https://doi.org/10.21980/J8204QIssue 3:2 No ratings yet.

Bedside ocular ultrasound revealed a serpentine, hyperechoic membrane that appeared tethered to the optic disc posteriorly with hyperechoic material underneath. These findings are consistent with retinal detachment (RD) and associated retinal hemorrhage.

Ophthalmology Ultrasound Visual EM

Intussusception

Julian Jakubowski, DO^*

DOI: https://doi.org/10.21980/J8SH0WIssue 3:2 No ratings yet.

A segment of bowel within the right abdomen that measured approximately 1.6 x 1.5 cm transaxially. It demonstrated a hypoechoic edematous outer loop of bowel (blue arrow) and hyperechoic compressed loop of bowel telescoping within (red star), this is known as the "target sign."

Abdominal/Gastroenterology Visual EM

Evaluation of Snake Bites with Bedside Ultrasonography

Josef E Jolissaint^*, Alexis Salerno, MD^{^} and Daniel Sheets, MD^{^}

DOI: https://doi.org/10.21980/J84S7D Issue 3:2 No ratings yet.

History of present illness: While watering his lawn, a 36-year-old man felt two sharp bites to his bilateral ankles. He reports that he then saw a light brown, 2-foot snake slither away from him. He came to the emergency department because of pain and swelling in his ankles and inability to bear weight. Physical examination revealed bilateral ankle swelling and

Wilderness Ultrasound Visual EM

A Case of Acute Cholecystitis

Chad Correa, BS^* and Lindsey Spiegelman, MD^{^}

DOI: https://doi.org/10.21980/J8405QIssue 3:1 No ratings yet.

Bedside point-of-care ultrasound revealed a distended gallbladder, thickened gallbladder wall, pericholecystic fluid, and a stone in the neck of the gallbladder indicative of acute cholecystitis.

Abdominal/Gastroenterology Visual EM

Computed Tomography and Ultrasound Diagnosis of Spontaneous Subcapsular Renal Hematoma

Samer Assaf, MD^*, Thalia Nguyen^* and Alisa Wray, MD^*

DOI: https://doi.org/10.21980/J8062DIssue 3:1 No ratings yet.

Bedside ultrasound was performed and demonstrated a hypoechoic area within the left kidney (images not shown). The non-contrast computed tomography (CT) of the abdomen and pelvis shows a significantly enlarged left kidney and a region of high-attenuation encapsulating the left kidney, concerning for acute hemorrhage.

Renal/Electrolytes Visual EM

Point-of-care Ultrasound for the Diagnosis of a Gluteal Abscess

Kevin Roy, BS^*, Robert Rowe, MD^* and Maili Alvarado, MD^{^}

DOI: https://doi.org/10.21980/J8VH1W Issue 3:1 No ratings yet.

POCUS reveals a large, hypoechoic soft tissue abscess with debris and tracks extending to the bottom of the image. Furthermore, when compressed, movement of the abscess contents is appreciated. There is also superficial cobble-stoning consistent with overlying cellulitis and soft tissue edema.

Ultrasound Infectious Disease Visual EM

Tricuspid Annular Plane Systolic Excursion (TAPSE) in a Patient with Pulmonary Emboli

Nicole Zawada, BS^*, Ethan Kunstadt, MD^* and Maili Alvarado, MD^{^}

DOI: https://doi.org/10.21980/J8M052 Issue 3:1 No ratings yet.

Video 1 and Image 1 show a thrombus in the patient’s IVC. Video 2 and Images 2-3 demonstrate a positive TAPSE of less than 17mm (blue arrow length) with a significantly dilated RV, indicating abnormal excursion of the tricuspid annulus and right ventricular dysfunction.

Respiratory Cardiology/Vascular Visual EM