Ultrasound of Colocolic intussusception:

 

<<sonographic images (Transverse and longitudinal)

<<CT scan images of the intussusceptum

<<CT scan images of the caecal mass

<<Colonoscopy reveals the culprit 

Can ultrasound be used in the diagnosis of intussusception? These sonographic images prove the point. Ileocolic intussusception is the commonest form of this condition. Less known is the colocolic type. This male patient presented with severe pain in the abdomen for past 8 months. The cause appears to be a mass in the caecum. CT scan images and colonoscopy reveal a large mass in the caecum. Histopathological study suggests adenocarcinoma. Ultrasound images reveal multiple alternating hypoechoic and hyperechoic layers of the colon within the colon, producing a “target sign” on transverse section of the affected region. Longtiudinal section images reveal a multiple layered appearance on ultrasound- the so called “sandwich” sign. The invaginated mesenteric fat and vessels are visible in these images.

Case and images courtesy of Dr. Ravi Kadasne, MD, UAE.

 

1) http://www.yoursurgery.com/ProcedureDetails.cfm?BR=1&Proc=81

2) http://www.emedicine.com/radio/topic366.htm

3) http://radiographics.rsnajnls.org/cgi/content/full/26/3/733 

 

For more ultrasound images of GI tract pathology, visit:

http://www.ultrasound-images.com/git.htm 

Sub-hepatic appendix:

Sonographic image showing relation to Rt. kidney/ liver

sonographic image showing relation to liver

CT image showing relation of sub-hepatic appendix to right kidney

CT image (coronal reconstruction) showing full extent of the appendix

 

This patient presented as a case of acute appendicitis. Ultrasound scan revealed the appendix extending from the right iliac region till behind the liver (sub-hepatic appendix). The appendix measured 22mm. in diameter s/o acute appendicitis. CT scan with coronal-reconstruction shows the full length of this organ. Ultrasound images, in both cross section and longitudinal planes show close relation of the organ to the antero-medial surface of the right kidney and posterior part of the liver.

Case courtesy of Dr. Ravi Kadasne, Radiologist, Al- Ein, UAE.

 

 

Ascariasis of small bowel:

internet marketing

 

ascariasis causing intestinal obstruction

ultrasound image of ascariasis of small bowel<<<<Linear structures within the bowel

sonographic image of small bowel ascariasis<<< dilated bowel loop and the ball of worms

snap of small bowel ascariasisPost-op pictures of bowel with multiple asacaris lumbricoides worms

snap of round worm mass in small intestine

picture of round worm balls in bowel<<Post-operative snap showing resected bowel with ball of round worms

Round worms or ascaris lumbricoides are known to cause intestinal obstruction, when these worms form a ball or mass. In this 5 yr. old child, more than 400 worms were removed surgically from the intestine. These ultrasound images, reveal multiple tubular structures (round worms, arrowed) within the intestine. One of the sonographic images shows an intertwined mass of worms with a resultant dilated bowel loop, suggesting the presence of intestinal obstruction.  The diagnostic feature of the round worms is the presence of multiple pairs of echogenic linear structures with a hypoechoic central portion. Real time sonography showed active movement of the worms.

 Images by Dr. Vikas Arora, Ferozepur, India.

 Reference:

1)      http://radiographics.rsnajnls.org/cgi/reprint/23/5/1291.pdf (free)

2)      http://www.jultrasoundmed.org/cgi/content/abstract/20/3/269 (free)