US Upper abdomen kidney spleen pancreas vessels bowel
US. Upper abdomen (kidney spleen pancreas vessels bowel) Suntharee moonrintah Radiologist NKP. Hospital 28 -6 -2060
Spleen • ������� intercostal approach �������������� supine ���� Rt. Lateral decubitus ����� Lt. subcostal approach ����� splenomegaly
Spleen Splenomegaly Common cause v. Heart failure v. Portal hypertension v. Leukemia v. Lymphoma v. Hepatitis v. Mononucleosis v. Generalized infection v. Hemolytic anemia Uncommon cause v. Glycogen storage disease v. Malaria v. Myelofibrosis
Splenomegaly Normal spleen: size ≤ 13 cm long, ≤ 6 cm thick
Pancreas • ������ head, neck, body, tail ��� uncinate process ���� head ������� IVC������ , body ������ vertebral body of L 1, tail ����������� spine ��� uncinate process ��������� head ����� inferomedial head body tail Splenic vein spine
Pancreas • ������ ��echo ������������������ • ������ homogeneous ��echo ����������� echo. Normal ������� liver parenchymal echo Normal pancreatic parenchymal echo
Pancreatic duct ��������� body of pancreas ������� echogenic line ���� lucency between two echogenic lines ������������ 2 �� CBD
Acute pancreatitis v. More difficult to image , Sensitivity 3390% v. US for Ø evaluate biliary tract ; stone and coexistent liver disease Ø FU lesion or fluid collection Ø intervention procedure
Acute pancreatitis Most common cause : Alcohol abuse , gallstones US findings; v May be normal in mild case v Decreased or heterogeneous pancreatic echogenicity v Diffuse or focal enlargement of pancreas, ill-defined border v Peripancreatic fluid (in subtle pancreatic abnormality( v Perivascular fluid collection v Perirenal fluid collection v Right pleural effusion
Acute pancreatitis
Chronic pancreatitis
Abdominal vessels Hepatic v. IVC Aorta MPV Celiac axis Biliary tree Splenic v. SMV SMA
Abdominal Aorta ������������ spine ������ Distal part : ������ Proximal part
Abdominal vessels �������. 1 Celiac artery ��������������������� diaphragm 1 -2 ��. ������� common hepatic trunk ��� splenic artery ��������� Common hepatic a. Splenic a. Celiac trunk Ao Celiac origin Aorta
Abdominal vessels. 2 Superior mesenteric artery ������ aorta ������� celiac a. ������������� aorta Liver Lt. lobe SMA aorta Sagittal scan SMA aorta transverse scan
Abdominal vessels 3. Gastroduodenal artery ���� common hepatic trunk �������������� anterolateral Gastroduodenal a. Distal CBD pancreas Branches ���� aorta ���� IMA ��� renal artery ������
Abdominal vessels . 4 Splenic vessels �������� hilum ��� spleen splenic vein ��������� < 10 ��.
Abdominal vessels 5. Portal vein ��������� splenic vein ��� SMV �������������������� < 13 ��. Lt. PV MPV Oblique scan Rt. PV Rt. subcostal scan
Stomach Liver : Lt. lobe stomach distended Stomach
Small Bowel in ascites Gas in bowel Fluid-filled bowel
Ascites
Lymphadenopathy v Discrete hypoechoic masses or anechoic masses without posterior enhancement, near the great vessels v nodal size criteria but normal nodal size could has disease
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