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Placenta previa and placental abruption
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Initially, transabdominal ultrasound was used for diagnosis. Transabdominal ultrasonography, however, may be limited by difficulty visualizing a posterior placenta, difficulty visualizing the lower uterine segment secondary to fetal positioning, and poor visualization in cases of maternal obesity (13). Although pelvic examination is contraindicated, clinical experience has shown that transvaginal ultrasound is safe to perform in patients with placenta previa (14). It has also been proven to be superior to abdominal ultrasound as diagnostic tool (15). Translabial ultrasounds can be of diagnostic assistance, but this technique does not appear to offer an advantage over transvaginal sonography. With the improved diagnostic accuracy of transvaginal ultrasound, in cases with a low-lying placenta, the ultrasound report should state the actual distance of the placental edge from the cervical os (13).
Pediatric Hematocolpos
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Omar M. Abuzeid, Mostafa I. Abuzeid
Transabdominal ultrasound scan can be helpful when the diagnosis is suspected. MRI should be ordered to confirm the diagnosis. MRI is helpful in detecting this anomaly early, and in turn, it allows early diagnosis and treatment [28]. The diagnosis can rarely be made in utero during maternal ultrasound by detecting pathologies such as hematocolpos or hydrometrocolpos [17].
Intraoperative Cholangiogram Shows <1 cm Stone at the Lower End
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Ultrasound: Transabdominal ultrasound should be the initial imaging performed when the clinical diagnosis is gallstone disease (Figure 27.1). The features suggesting associated common bile duct stones are a dilated common bile duct greater than 7 mm, or the presence of stones in the common bile duct.
Application of ultrasonography in predicting the biological risk of gastrointestinal stromal tumors
Published in Scandinavian Journal of Gastroenterology, 2022
Jing-Jing Guo, Xiu-Bin Tang, Qing-Fu Qian, Min-Ling Zhuo, Li-Wu Lin, En-Sheng Xue, Zhi-Kui Chen
Color Doppler ultrasonic diagnosis apparatus was used (Toshiba Aplio 500, Supersonic Aixplorer, PHILIPS EPIQ5, and GE LOGIQ E9). Transabdominal ultrasound was performed using a convex array probe with a frequency of 3–5 MHz and a line array probe with a center frequency of 7 MHz. Patients fasted for at least 8 h and defecated before ultrasonography. In addition, gastrointestinal ultrasound contrast agents were used for gastric GISTs and oral isotonic mannitol for extra-gastric GISTs. The internal echo (hypoecho and isoecho), echo homogeneity (homogeneous and inhomogeneous), boundary (clear and unclear), shape (regular and irregular), blood flow signals of the lesion (according to the Alder blood flow classification [grade 0 and grade 1 were merged as low blood supply, and grade 2 and grade 3 were merged as multiple blood supply]), presence of necrotic cystic degeneration (necrotic areas were diagnosed from sharply demarcated anechoic areas), the long diameter of lesions (≤2.0 cm; >2.0 and ≤5.0 cm; >5.0 and ≤10.0 cm;>10.0 cm), and the short/long (S/L) diameter ratio were recorded in detail.
Successful hysteroscopic treatment of a cervical heterotopic pregnancy: case report and literature review
Published in Journal of Obstetrics and Gynaecology, 2020
Antonio Rubattu, Valentina Corda, Iside Derosas, Maria Carla Monni, Cristina Nocco, Ambra Iuculano, Giangavino Peppi, Nadia Rosas, Giovanni Ruiu, Giovanni Monni
The patient was informed about her diagnosis and counselled about the possible complications including life-threatening haemorrhage, as well as about the therapeutic approaches. After giving her informed consent, she opted for hysteroscopic excision of the cervical gestational sac to preserve the intrauterine pregnancy. The procedure was performed under a general anaesthesia using a 3.5 mm bipolar hysteroscope [Versascope (Gynecare, Ethicon, USA)] which was introduced in the cervix without the use of a speculum or cervical dilators (Figure 1). The entire procedure was performed under transabdominal ultrasound guidance. Saline solution was used as the distention medium and the tip of the hysteroscope was not advanced beyond the internal cervical os. After an incision was made in the gestational sac of the CP, the cervical embryo was coagulated with bipolar forceps. The β-hCG level after the hysteroscopic surgery was 35,933 mIU/mL. The intraoperative and postoperative bleeding was minimal. An ultrasound performed on post-operative day number one confirmed a viable intrauterine pregnancy without any evidence of residual pregnancy in the cervix. The intrauterine pregnancy continued without complications and the follow-up ultrasounds were unremarkable. The patient underwent an uncomplicated caesarean delivery at 39 weeks of gestation of a healthy female weighing 2900 g, with Apgar scores of 9 and 10 at 1 and 5 min, respectively. The patient did not experience any postpartum complications.
Long-term outcomes of endoscopic ultrasound-guided laser ablation for liver tumors in the caudate lobe: 5 years of experience
Published in Scandinavian Journal of Gastroenterology, 2023
Min Xu, Danxia Xu, Zhuang Deng, Guo Tian, Tian’an Jiang
A previous study reported that, after percutaneous ablation, the incidence of LTP of tumor in the caudate lobe was higher compared with tumor in other areas of the liver [25]. In the present study of EUS-LA of liver tumor in the caudate lobe, the LTP rates at 1 and 3 years were 16.8% and 23.7%, respectively. This is lower than the rates reported earlier for percutaneous ablation, and approximately equal to that for noncaudate lobe tumor [19]. Using EUS, the transducer can be brought close to the liver, which allows clearer visualization of the caudate lobe tumor compared with transabdominal ultrasound. Thus, EUS-guided ablation can achieve a sufficient margin and improves clinical efficacy.