By Jane Bates
Ultrasound remains to be essentially the most very important diagnostic instruments in drugs and is utilized by a variety of healthcare execs throughout many purposes. This booklet offers a pragmatic, clinically suitable advisor for all practitioners operating within the box of belly ultrasound. Its target is to allow the operator to maximise the diagnostic info and realize the constraints of ultrasound scans.
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Extra resources for Abdominal Ultrasound: How, Why and When (3rd Edition)
36). Be suspicious of a diameter of 10 mm or more as this is associated with obstruction due to formation of stones in the duct. Techniques The main, right and left hepatic ducts tend to lie anterior to the portal vein branches, however, as the biliary tree spreads out, the position of the duct relative to the portal branches is highly variable. Do not assume that a channel anterior to the portal vein branch is always a biliary duct – if in doubt, use colour Doppler to distinguish the bile duct from the portal vein or hepatic artery.
39 2 The normal hepato-biliary system Fig. 31 • Double gallbladder: an incidental finding in a young woman. A • Check the patient has fasted • Look for an ectopic gallbladder – positioned low in the pelvis for example • Check that near-field artefact has not obscured an anterior gallbladder – a particular problem in very thin patients. If you still cannot find it, ensure the scanner frequency and settings are optimized, find the porta hepatis and scan just below it in transverse section. This is the area of the gallbladder fossa and you should see at least the anterior gallbladder wall if the gallbladder is present (Fig.
A low velocity is associated with portal hypertension. ) The portal venous system MHV RHV LHV Middle RHV Inferior RHV A IVC B Fig. 23 • (A) Configuration of the hepatic venous system. (B) Inferior middle hepatic vein (arrow) draining into the IVC. Fig. 25 • TS through the epigastrium demonstrating the normal splenic vein with flow towards the liver. Note the change from red to blue as the vessel curves away from the transducer. Fig. 24 • Main portal vein at the porta hepatis demonstrating hepatopetal flow.