Diagnostic Ultrasound - Abdomen and Pelvis

Diffuse Peritoneal Fluid
Hemoperitoneum
Hemoperitoneum
(Left) Transverse ultrasound of
the left lower quadrant in a
liver transplant recipient is
shown. Low-level echoes ſt in
the nonseptated ascites were
shown to be secondary to
hemorrhage at paracentesis.
Bowel was not floating,
secondary to mass effect.
(Right) Longitudinal
ultrasound of the left upper
quadrant after liver
transplantation is shown.
There are multiple avascular
fibrinous septa within
chronic hemorrhagic ascites
inferior to the spleen st and
left kidney ſt.
Differential Diagnoses:
Abdominal Wall/Peritoneal Cavity
Pyogenic Peritonitis
Carcinomatosis
(Left) Transverse ultrasound of
the mid abdomen in a patient
with heart failure and fever is
shown. Fluid with layering
low-level echoes ſt is noted
with dependent, more solid
debris st. Aspiration showed
pus. (Right) Transverse
ultrasound of the pelvis shows
complex ascites with low-level
echoes ſt in a patient with
liver and renal transplants.
Aspiration showed malignant
cells from ovarian carcinoma.
Subtle peritoneal nodularity
was present.
Carcinomatosis
Ruptured Ovarian Cyst or Ectopic
Pregnancy
(Left) Transverse ultrasound of
the right upper quadrant in a
patient with appendiceal
pseudomyxoma peritonei is
shown. There are numerous
septa in the gelatinous fluid
ſt surrounding the liver .
(Right) Longitudinal
transabdominal pelvic
ultrasound shows echogenic
hemorrhagic fluid ſt superior
to the uterus, and less
echogenic fluid in the cul-desac
st from a ruptured ectopic
pregnancy. Note the
endometrial thickening .
Ruptured ovarian cysts may
present similarly. Knowledge
of pregnancy status is key.
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