วันอาทิตย์ที่ 6 พฤศจิกายน พ.ศ. 2559

Abdominal pain in adult: Ultrasound approach

Abdominal Pain

Locations

 RUQ

  Biliary

   Cholecystitis  Link of cholecystitis

    Acute
    Chronic  Link of chronic cholecystitis
   Cholelithiasis (gallstone)   Link of gallstones
   Cholangitis Link  picture cholangitis

  Colonic

 Colitis   Link of colitis
   Diverticulitis  Link of diverticulitis

  Hepatic

   Abscess  Link of hepatic abscess
   Hepatitis Link of hepatits 
   Mass  Link of hepatic mass

  Pulmonary

   Pneumonia: Ultrasound video of pneumonia
   Embolus   (CT is image modality of choice) indirect sign is pulmonary infarct (like pneumonia), pleural effusion 

  Renal

   nephrolithiasis: Example pictures of renal stone
   Pyelonephritis: Example pictures of pyelonephritis

 Epigastric

  Biliary

   Cholecystitis  Link of cholecystitis
    Acute
    Chronic
   Cholelithiasis (gallstone) Link of cholelithiasis
   Cholangitis  Link of cholangitis

  Cardiac

   Myocardial infarction  Ultrasound cannot demonstrate
   Pericarditis  Ultrasound can detected thick pericardium or pericarial effusion

  Gastric

   Esophagitis  Best seen with endoscopy
   Gastritis     Best seen with endoscopy
   Peptic ulcer   Best seen with endoscopy
   Gastric Mass: Some time gastric tumor can be detected by ultrasound (Link of US image of gastric mass)

  Pancreatic

   Mass  
Link of pancreatic head carcinoma
Link of pancreatic body and tail malignancy
   pancreatitis  Link of pancreatitis

  Vascular

   aortic dissection: Mostly seen by contrast CT scan, sometime US can detected dissection
   Mesenteric ischemia Mostly detected by CT scan

 LUQ

  Cardiac

   Angina
   Myocardial infarction  Ultrasound cannot demonstrate
   Pericarditis  Ultrasound can detected thick pericardium or pericarial effusion

  Gastric

   Esophagitis  Best seen with endoscopy
   Gastritis    Best seen with endoscopy
   Peptic ulcer   Best seen with endoscopy
   Gastric Mass: Some time gastric tumor can be detected by ultrasound (Link of US image of gastric mass)

  Pancreatic

   Mass
                Link of pancreatic head carcinoma
     Link of pancreatic body and tail malignancy
               
   pancreatitis  Link of pancreatitis

  Renal

   nephrolithiasis   Link of nephrolithiasis
   Pyelonephritis  Link of pyelonephritis

  Vascular

   aortic dissection Mostly seen by contrast CT scan, sometime US can detected dissection
   Mesenteric ischemia  Mostly detected by CT scan

 Periumbilical

  Gastric

   Esophagitis    Best seen with endoscopy
   Gastritis    Best seen with endoscopy
   Peptic ulcer    Best seen with endoscopy
   Gastric Mass: Some time gastric tumor can be detected by ultrasound (Link of US image of gastric mass)
   Small bowel mass  Link of small bowel mass
   Small bowel obstruction best see with radiography and CT scan

  Colonic

   Early appendicitis: Link of US of uncomplicated appendicitis
                                 Link of complicated appendicitis

  Vascular

   aortic dissection Mostly seen by contrast CT scan, sometime US can detected dissection
   Mesenteric ischemia  Mostly detected by CT scan

 Periumbilical

 RLQ

  Colonic

   appendicitis:  Link of US of uncomplicated appendicitis
                         Link of complicated appendicitis
   colitis     Link of colitis
   diverticulitis    Link of diverticulitis
   IBD : Link of IBD
   IBS : Diagnosis by exclusion of other diseases, No image abnormality

  Gynecologic
   Ectopic pregnancy: Link of ectopic pregnancy
   Fibroids:  Link of uterine fibroid
   Ovarian mass Link of ovarian lesions
   Tortion Link to video of ovarian tortion
   PID Link of PID

  Renal

   nephrolithiasis  Link of nephrolithiasis
   Pyelonephritis   Link of pyelonephritis

 Suprapubic

  Colonic

   appendicitis Link of US of uncomplicated appendicitis
                       Link of complicated appendicitis
   colitis     Link of colitis
   diverticulitis    Link of diverticulitis
   IBD : Link of IBD
   IBS : Diagnosis by exclusion of other diseases, No image abnormality

  Gynecologic

  Ectopic pregnancyLink of ectopic pregnancy
   Fibroids:  Link of uterine fibroid
   Ovarian mass Link of ovarian lesions
   Tortion Link to video of ovarian tortion
   PID Link of PID

  Renal

   Cystitis  Acute cystitis shows normal bladder on US, Chronic cystitis shows diffused bladder wall thickening
   nephrolithiasis  Link of nephrolithiasis
   Pyelonephritis   Link of pyelonephritis

 LLQ

  Colonic

   colitis     Link of colitis
   diverticulitis    Link of diverticulitis
   IBD : Link of IBD
   IBS : Diagnosis by exclusion of other diseases, No image abnormality

  Gynecologic

  Ectopic pregnancyLink of ectopic pregnancy
   Fibroids:  Link of uterine fibroid
   Ovarian mass Link of ovarian lesions
   Tortion Link to video of ovarian tortion
   PID Link of PID

  Renal

   nephrolithiasis  Link of nephrolithiasis
   Pyelonephritis   Link of pyelonephritis

 Any location

  Abdominal wall

   herpes zostor
   muscle strain
   hernia  Link of abdominal wall hernia

  Other

   bowel obstruction
   mesenteric ischemia
   peritonitis
   narcotic withdrawal
   sickle cell crisis
   porphyria
   IBS
   Heavy metal poisoning

Note:

IBD = Inflammatory Bowel Disease
IBS = Irritable Bowel Syndrome
PID = Pelvic Inflammatory Disease