Unique Radiologist

◇◇◇A Case Of Pyogenic Hepatic Abscess◇◇◇

Clinical History (Hx):-
35 years male patient presented with fever, right upper quadrant pain and tenderness.

Ultrasound Findings:-
A well-defined hypoechoic lesion measuring approximately (111 × 85 x 70 mm, Volume:- 660ml) is seen in the right lobe.
•Lesion shows irregular walls, internal low-level echoes, and no significant internal vascularity on color Doppler — suggestive of pus content.
•Surrounding parenchyma appears mildly hyperechoic (reactive changes).
•No calcification or gas foci seen within the lesion.
•Intrahepatic biliary radicals: Normal caliber.
•Portal vein and hepatic veins: Normal flow pattern.

Impression:- Findings are suggestive of A Pyogenic Hepatic Abscess involving the right lobe of liver.

Causal Explanation:

The abscess is likely secondary to bacterial infection, commonly due to ascending infection via the biliary tract, portal vein seeding from gastrointestinal infection, or hematogenous spread (e.g., from septic focus elsewhere).
Most frequent organisms: E. coli, Klebsiella, Staphylococcus.

Recommendations:
•Contrast-enhanced CT (CECT) Abdomen for confirmation and extent assessment.
•Antibiotic therapy as per culture sensitivity (blood or aspirate).
•Image-guided aspiration / pigtail drainage if lesion is large or not responding to medical therapy.
•Follow-up ultrasound after 7–10 days to monitor resolution.

◇◇◇A Case Of Right tubal live ectopic pregnancy◇◇◇

Clinical History:~ 25 Years female patient present with acute lower abdominal pain (right-sided) and 06 weeks amenorrhea.

Technique:~ Transabdominal ultrasound performed using grayscale and color Doppler imaging. Limited evaluation of upper abdomen included.

Findings:~
Uterus:~Normal in size, shape, and echotexture.
Endometrial cavity appears empty.
No intrauterine gestational sac visualized.

Right Adnexa:~A well-defined extrauterine gestational sac is identified in the right adnexal region measuring approximately 14 × 8 × 11 mm
Internal contents:~
Yolk sac visualized (~4 mm)
Embryo present
Crown-rump length (CRL): ~3.5 mm, corresponding to ~6 weeks gestation
Cardiac activity detected, fetal heart rate ~86 bpm.

A large surrounding heterogeneous collection/hematoma measuring approximately 11 × 4 cm is noted encasing the gestational sac.

Left Adnexa:~Appears normal.
No adnexal mass or abnormality detected.

Pouch of Douglas:~Mild to moderate fluid collection present.

Others:~Moderate fluid collection with internal echoes (internal blood) seen in the hepatorenal pouch (Morison’s pouch) suggestive of hemoperitoneum.

Impression:~Live right adnexal ectopic pregnancy (likely tubal)
Gestational age ~6 weeks.
Fetal cardiac activity present.
Large perigestational adnexal hematoma.
Moderate hemoperitoneum, extending into the hepatorenal pouch.

Conclusion:~Findings are diagnostic of a live right tubal ectopic pregnancy with associated hematoma and hemoperitoneum, indicating a high risk of rupture.

Recommendations:~URGENT gynecological referral
Immediate clinical correlation and management
Serum β-hCG correlation
Close hemodynamic monitoring

DIAGNOSE OF RIGHT O***Y 😱 🤔|| COMMENTS ON 👇👇

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DIAGNOSE OF LIVER 😱🤔||COMMENTS ON 👇👇||
10Y/M PATIENT PRESENTS WITH FEVER AND PAIN

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***y Unique Radiologist

◇◇◇A Case Of Subacute Small Bowel Obstruction (SBO)◇◇◇

Clinical History (Hx):~ 24 Years Female Patient presents with Intermittent abdominal pain (predominantly left lower abdomen)
Abdominal distension
Nausea with occasional vomiting
History suggestive of prior abdominal surgery.

Technique:~ Real-time transabdominal ultrasound examination performed using a curv and linear probe. Grayscale and limited peristaltic assessment done.

Findings:~ Multiple dilated small bowel loops are noted, predominantly involving the proximal ileum, located in the left lumbar region and left iliac fossa.
The maximum bowel loop diameter measures approximately 29 mm, suggestive of significant dilatation.
The dilated loops are filled with echogenic intraluminal contents (food residue).
Peristalsis appears sluggish, consistent with subacute obstruction.
A well-defined transition point is identified in the left paramedian infraumbilical region, beyond which the bowel loops appear collapsed.
No obvious mass lesion or hernia is identified at the transition site.
Findings are highly suggestive of a mechanical obstruction, most likely due to bowel adhesions.
No significant free fluid is noted in the abdomen.
No evidence of bowel wall thickening, pneumatosis, or portal venous gas on current examination.

Impression:~ Dilated proximal ileal loops (max diameter ~29 mm) with intraluminal food residue and a distinct transition point in the left infraumbilical region.
Findings are suggestive of Subacute Small Bowel Obstruction (SBO)
Most likely etiology: Post-surgical bowel adhesions.

Recommendations:~ Clinical correlation and surgical evaluation advised
Consider contrast-enhanced CT abdomen for further evaluation of transition point and cause
Monitor for signs of complication (strangulation/ischemia)

Unique Radiologist

◇◇◇A Case Of Scar Endometriosis◇◇◇

Clinical History (Hx):- 25 Years Female patient presents with pain and swelling in the lower abdomen, predominantly on the left side.
One year ago LSCS done.

Technique:- High-resolution ultrasound examination of the anterior abdominal wall was performed using a high-frequency linear transducer with grayscale and color Doppler evaluation.

Findings:-An irregular, heterogeneously hypoechoic lesion measuring approximately 6.0 × 2.2 × 5.0 cm (SI × AP × TR) is noted in the left lower anterior abdominal wall.
The lesion is located within the muscle plane, involving the left re**us abdominis muscle, and is contained within the re**us sheath.

Internal architecture:- Multiple small cystic areas are seen within the lesion.
No obvious calcification is identified.
Color Doppler:
Increased internal vascularity is noted.

Surrounding structures:- No evidence of intra-abdominal extension.
Adjacent abdominal wall planes are preserved.

Impression:- Findings are highly suggestive of scar endometriosis involving the left re**us abdominis muscle.

Recommendations:- Clinical correlation with history of prior surgery is strongly advised.
Surgical consultation is recommended for further management.
Histopathological confirmation should be considered for definitive diagnosis.