超声诊断腰大肌寒性脓肿1例

患者 ,男性 ,2 3岁。广西回族人。主因腹胀满、右腹股沟肿物一个月来我院就诊。既往体健。外科查体 :右髂窝似扪及一包块 ,边界不清。要求超声协助诊断。采用 ASU- 30 0 0彩色超声检查仪 ,探头频率3.5 MHz。腹部超声所见 :腹腔内沿双侧腰大肌内侧可探及左侧 14 .7cm× 5 .3cm (图 1)和右侧 15 .4 cm×5 .9cm(图 2 )囊性透声区 ,边界清晰 ,自腰部一直延图 1　左侧腰大肌脓肿伸至髂窝部 ,其内可见散在点状或斑块状偏强回声。后方回声增强。超声诊断 :腰大肌囊性肿物 ,寒性脓肿 ?后经 X线及 CT检查诊断为腰椎结核合并椎旁脓肿。经手术病理…     

小肠坏死超声表现1例

患者女,37岁.主因腹部疼痛12 h入院,2年前曾因"卵巢囊肿"行手术治疗. 经腹部超声检查:右髂窝及盆腔左侧近左髂窝处见小片状无回声区,深度分别为0.7 cm、0.4 cm,内透声差.子宫左后方见一无回声包块,范围约10.2 cm×5.3 cm×5.4 cm,边界清,透声差,其后方见一不规则、不均匀无回声包块,内可见密集细小点状高回声沉积于后壁;右侧腹部也可见近似回声,范围约7.2 cmx 6.0 cm;左侧腹部见一不均匀团状低回声,范围约8.0cm×3.7 cm,内见小片状无回声及点片状高回声;上述包块均未见明显蠕动.     

隐睾卵黄囊瘤1例

患者男,29岁,无明显诱因出现间断性右下腹疼痛2个月.体检:右下腹以耻骨联合之上右侧区域压痛明显,有轻度反跳痛,无肌紧张,麦氏点无明显压痛,右侧睾丸缺失.超声检查:右下腹可见大小约10.2 cm×8.6 cm的中等回声包块,边界清楚,有包膜,有一定移动度,内部回声不均匀,可见不规则的无回声区(图1);CDFI:包块内部血流信号较丰富,周边可见少量血流.     

右下腹腹壁结核性脓肿误诊为血肿1例

患者男,42岁,发现右下腹腹壁包块3个月余,近来增大明显。体格检查:右下腹腹壁可扪及一质软包块,边界清,压之可变形,触诊有波动感,揉压有隐痛。超声表现:右下腹腹壁可见一大小约83mm×46mm×32mm的囊性包块(图1),形态欠规则,边界清,后方可见约38mm的缺口,与右侧腹股沟相通,囊内充满点状弱回声,加压后可见点状弱回声经缺口呈往返运动,似"飘雪"状,彩色多普勒血流成像示红蓝相间的彩色血流信号     

超声诊断输卵管卵巢脓肿1例

1病历摘要女,35岁。因发现盆腔肿物1个月、腹痛5 d入院。1个月前患者因腹痛B超检查发现右附件囊肿,抗炎治疗后好转,5 d前再次腹痛,为坠痛,向后腰部放散,腹痛无缓解故来院诊治。查体:T 36.6℃,BP 110/70 mm Hg,心肺无异常,腹软,无压痛。妇科检查:宫颈光滑,子宫常大,于右附件区可及一囊性肿物约10 cm×7 cm,右边界清,左边界与子宫分界不清,压痛明显。超声所见:子宫后位,大小6.1 cm×5.0 cm×5.2 cm,表面光滑,实质回声欠均,未见明显占位性病变。内膜居中,宫内节育器位置正常。于陶氏腔见液性暗区,厚约0.9 cm。右附件区可见一11.4cm×7.4 cm低无回声团,形态尚规则,内回声不均,可见6.1 cm×3.0 cm无回声,周边为低回声,彩色显示血流信号丰富,R I0.69,左附件(-)。超声诊断:(1)右附件囊实性包块性质待定;(2)盆腔积液。血常规:W BC 17.6×109/L,手术见盆腔有血性渗出约100 m l,子宫正常大小,表面光滑、充血,左附件外观正常,右侧圆韧带及骨盆漏斗韧带增粗、水肿,右附件区有一9 cm×8 cm×8 cm肿物,与子宫及盆壁广泛粘连,...     

彩色多普勒超声诊断甲状腺癌伴囊腺瘤1例

患者男,30岁.近日发现颈部无痛性包块而来就诊.临床考虑甲状腺疾患要求超声检查.超声检查:右侧甲状腺外形失常,体积增大,其下极可见一4.1 cm×3.5 cm×2.6 cm囊实性肿物,明显向外突,边界清,有包膜,后方回声增强,内可见密集的点状回声及乳头状强回声突入囊内(图1).于其中上极另见多个低回声结节,边界欠清,后方回声衰减,内部回声不均匀,可见多个点状强回声(图2).彩色能量多普勒显示低回声结节周围及内部血流信号丰富,脉冲多普勒可探及高速动脉血流频谱.右叶下极边缘可见残存的小片正常甲状腺组织.     

回盲部混合性腺神经内分泌癌1例

患者女,63岁,因自觉下腹部钝痛不适4月余就诊。查体:无特殊。肿瘤标志物正常范围。超声:膀胱右侧髂血管左上方探及一不均质偏低回声包块,约6.50cm×6.20cm,呈类圆形,边界欠清,内部回声混杂;CDFI:内部可见点状血流信号,PW可见低阻动脉频谱,与右侧卵巢关系不密切,双侧正常卵巢显示清晰,子宫直肠窝可     

超声诊断正中神经鞘瘤1例

患者女,53岁.主因"右上臂包块2个月"就诊,无上臂感觉异常及其他不适.查体:右上臂上段内侧距腋窝6 cm处扪及一肿块,大小约2 cm×3 cm×1 cm,边界清,质硬,表面光滑,活动度可,无压痛,按压包块右手指有触电样感觉.超声见:右上臂上段内侧肌间探及一椭圆形低回声包块,大小约2.3 cm×3.2 cm×1.3 cm,边界清,有包膜,其上下端与正中神经相连,呈"鼠尾"征,神经受压位于包块一侧,包块左侧缘紧贴肱动、静脉,CDFI示肿块内可见稀疏的点状血流信号.超声提示:右上臂上段内侧实性肿块(考虑正中神经鞘瘤).     

超声诊断以淋巴结转移为首发症状的前列腺癌一例

1临床资料患者,男,71岁。因右下腹部扪及包块前来就诊。超声检查:自脐上约7cm腹主动脉周围至右侧髂血管周围可见多个大小不等的低回声结节,最大者5.9cm×3.9cm,位于右侧髂内静脉后方。腹腔脏器扫查未见明显异常。前列腺扫查可见增大,向膀胱内突起,内部回声不均匀,见多个低回声结节,最大者2.1cm×1.2cm,形态不规则,边缘     

脾动脉栓塞术后并发脾脓肿超声表现一例

患者女,44岁.主诉:腹胀、乏力2个月.患者2个月前无明显诱因出现腹胀乏力、伴双下肢中度水肿.外院就诊超声检查提示:肝硬化、门静脉、脾静脉增宽,肝内略增强回声结节,腹腔积液.乙肝系列:HBsAg(+)、抗HBe(+)、抗HBC.行脾动脉栓塞术后,为进一步诊治入我院.查体:全身皮肤黏膜轻度黄染,左上腹部膨胀,脾脏肋下可触及(肋下7 cm,Ⅰ线7 cm,Ⅱ线13 cm,Ⅲ线+1 cm),质硬,表面光滑,无触痛,脾脏叩诊增大.胸腹部CT:左侧胸腔大量积液;左肺下叶不张.临床诊断:肝炎后肝硬化(乙型、失代偿);脾脏部分动脉栓塞术后.超声检查:左上腹部脾窝处可探及29 cm×21 cm囊性包块,内部为无回声区,内见点状强回声,边界清,形态不规则(图1).行超声引导下左上腹部脾窝处脓肿置管引流术,在超声引导下18 G穿刺针穿刺入包块内部,置入7 F中心静脉导管(图2),抽取20 ml黏稠深红色脓性液体,送病理检查,中心静脉管引流通畅,固定良好,安全返回病房.最终诊断:脾脓肿.     

Psoas abscess

A psoas abscess is infrequently diagnosed on initial presentation. This report reviews the presentation of a patient with a complicated psoas abscess. The pathophysiology and the clinical and laboratory presentation of patients with this disease entity are reviewed.     

Hepatic abscess following transhepatic drainage of subphrenic abscess

A case of an hepatic abscess that developed after percutaneous transhepatic drainage of a subphrenic abscess is presented. The location of the abscess immediately along the tract of the drainage catheter and the similar organisms recovered from bacteriologic culture suggest that the abscess was related to direct contamination along the tract of the drainage catheter. The potential for abscess formation within the liver should be considered in the choice of access route for percutaneous drainage of retroabdominal abscesses. It may be preferable to avoid transhepatic drainage in patients in whom it is anticipated that the catheter drainage will require considerable length of time.     

Peritonsillar abscess

Peritonsillar abscess remains the most common deep infection of the head and neck. The condition occurs primarily in young adults, most often during November to December and April to May, coinciding with the highest incidence of streptococcal pharyngitis and exudative tonsillitis. A peritonsillar abscess is a polymicrobial infection, but Group A streptococcus is the predominate organism. Symptoms generally include fever, malaise, sore throat, dysphagia, and otalgia. Physical findings may include trismus and a muffled voice (also called "hot potato voice"). Drainage of the abscess, antibiotics, and supportive therapy for maintaining hydration and pain control are the foundation of treatment. Antibiotics effective against Group A streptococcus and oral anaerobes should be first-line therapy. Steroids may be helpful in reducing symptoms and speeding recovery. To avoid potential serious complications, prompt recognition and initiation of therapy is important. Family physicians with appropriate training and experience can diagnose and treat most patients with peritonsillar abscess. (Am Fam Physician.     

Brain abscess

The results of CT brain scan in diagnosing and monitoring the course of brain abscesses and the recognition of the major role that anaerobic bacteria play in causing this disease have led to a reduction in disease mortality and have allowed a greater percentage of infected patients to recover without major neurosurgical procedures. Monitoring intracranial pressure, the availability of new antibiotics, and recognition and treatment of some of the more unusual syndromes associated with defective or suppressed immune systems have helped lead to a reduction in disease mortality from about 50 per cent to 10 per cent with excellent functional recovery in the majority of the patients.