Word of the Day – “Morisons Pouch”

Word of the Day

Morisons Pouch

morissonNamed after the British surgeon James Rutherford Morison, Morison’s pouch is also known as the hepatorenal recess or the subhepatic recess (the space that separates the liver from the right kidney). This recess is free of fluid under normal circumstances, but can fill with fluid under certain conditions such as hemoperitoneum or ascites. This space can best be visualized via ultrasound. According to the Textbook of Pediatric Emergency Medicine, “The amount of intraperitoneal fluid needed for detection by ultrasound has been reported to be as little as 100 mL and will depend on the source of the bleeding and patient positioning.” In adults, any low frequency probe is adequate to visualize the space. However, in pediatric trauma patients who have small intercostals spaces a microconvex probe should be used to avoid rib shadowing. Morison’s Pouch is one of the 4 views of the FAST exam.

References: Textbook of Pediatric Emergency Medicine 6th Edition pages 1732-1733. Edited by Gary Robert Fleisher and Steven Ludwig

To learn more about Morison’s Pouch, and how to identify it during your evaluations, check out upcoming Abdominal hands-on training course that will provide hours of hands-on scanning.

Word of the Day – Hepatitis

Word of the Day

Hepatitis – inflammation of the liver

HepatitisThe “Starry Night” Pattern

A common (but not universal) sonographic finding in Hepatitis is Hepatomegaly: The so-called “starry night liver”.  Hepatomegaly and inhomogeneous patchy or diffuse increased echogenicity are common in chronic hepatitis and are related to the amount of fatty infiltration and fibrosis present.  Read more at the link below…

http://www.jultrasoundmed.org/content/21/9/1023.full.pdf

 

 

 

Word of the Day – Appendicitis

Gulfcoast Ultrasound Institute - Word of the Day

Appendicitis

Normal Appendix vs AppendicitisAppendicitis – inflammation of the vermiform appendix.
With an incidence of 1 in 4,000 children under the age of 14 in the United States this is the most common condition requiring emergency surgical intervention in children. Sonography is the primary method of imaging for appendicitis.
Normal Anatomy:  The normal appendix is a tubular, compressible structure that should arise from the cecal tip approximately 1 cm below the terminal ileum. It is usually anterior to the psoas muscle and iliac vessels.
Ultrasound Diagnostic Criteria: The accepted criteria for diagnosing an acute appendicitis by ultrasonography are the identification of a non-compressible, non-peristaltic blind-ending tubular structure in the longitudinal axis and target like appearance in transverse.  The diameter should not exceed 6 mm when measured outer-to- outer. An Appendicolith may be present however is not present in all reported cases.

References:
Munden MM, Hill JG. Ultrasound of the acute abdomen in children. Ultrasound Clin. 2010;5:113-135
Donald Venes, eds. Taber’s Cyclopedic Medical Dictionary: Publisher; 2009.

To learn more about Appendicitis, and how to identify it during your evaluations, check out upcoming Abdominal hands-on training course that will provide hours of hands-on scanning.