By Jane A. Smith (formerly Bates) MPhil DMU DCR
As a growing number of practitioners are hoping on ultrasound as an authorised, secure, and reasonable diagnostic instrument in daily perform, its use in diagnosing stomach difficulties is readily expanding. This up to date variation contains insurance of easy anatomy, strategy, and ultrasound appearances, as well as the most typical pathological techniques. It serves as either a pragmatic, clinically proper guide and source for execs, in addition to a useful textbook for college kids coming into the sphere. * Over 500 illustrations and fine quality scans truly express belly anatomy. * sensible and clinically suitable assurance addresses the worries of either practitioners and scholars. * Succinct, entire chapters express small print.
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Additional resources for Abdominal Ultrasound How, Why and When
Respiratory modulations are evident. ● The gallbladder may be ‘folded’ (the so-called Phrygian cap). To interrogate its contents fully, unfold it by turning the patient decubitus (right side raised), almost prone or erect (Fig. 30). ● Bowel gas over the fundus can also be moved by various patient positions. Normal variants of the gallbladder The mesenteric attachment of the gallbladder to the inferior surface of the liver is variable in length. This gives rise to large variations in position; at one end of the spectrum the gallbladder, attached only at the neck, may be fairly remote from the liver, even lying in the pelvis; at the other the gallbladder fossa deeply invaginates the liver and the gallbladder appears to lie ‘intrahepatically’ enclosed on all sides by liver tissue.
Presse Medical 62: 709. 3. Conlon RM, Bates JA. 1996 Segmental Localisation of Focal Hepatic Lesions – A Comparison of Ultrasound and MRI. Conference proceedings of BMUS, Edinburgh. 4. Cheng Y, Huang T, Chen C et al. 1997 Variations of the middle and inferior right hepatic vein: application in hepatectomy. Journal of Clinical Ultrasound 25: 175–182. 5. Goyal AK, Pokharna DS, Sharma SK. 1990 Ultrasonic measurements of portal vasculature in diagnosis of portal hypertension. Journal of Ultrasound in Medicine 9: 45.
In 15–35% of patients the left hepatic vein (LHV) and middle hepatic vein (MHV) are separate. This usually has no significance to the operator. However, it may be a significant factor in planning and performing hepatic surgery, especially tumour resection, as the surgeon attempts to retain as much viable hepatic tissue as possible with intact venous outflow (Fig. 4 Haemodynamics of the liver Pulsed and colour Doppler to investigate the hepatic vasculature are now established aids to diagnosis in the upper abdomen.