Jejunal Bowel Loop Hematoma: An Ultrasound diagnosis 2013

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Jejunal Bowel Loop Hematoma: An Ultrasound diagnosis 2013

Post by Admin on Sun Sep 15, 2013 5:22 am

2013 2013 2013 <div dir="ltr" style="text-align: left;" trbidi="on"><div class="MsoNormal" style="text-align: justify;"><span lang="EN-IN" style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 115%;">A 6 yrs old female child with h/o &nbsp;blunt abdominal trauma 3 days back, episode of malena, &amp;&nbsp; having pain abdomen,&nbsp; was referred for ultrasound evaluation &nbsp;of abdomen .&nbsp; At USG&nbsp; a well defined hypoechoic&nbsp; oval mass was seen along jejunal&nbsp; bowel loop,&nbsp; likely involving its wall, with slight exophytic bulge , &amp; focally distorting gut signature [ fig 1 &amp; 2] . The mass&nbsp; did not reveal internal vascularity on Doppler.&nbsp; The affected segment of jejunum&nbsp; was sluggishly motile , &amp;&nbsp; showed mild luminal narrowing&nbsp; with&nbsp; proximal fullness.&nbsp; Surprisingly no any other evidence of intraabdominal free fluid , mesenteric mass or fluid ,or solid visceral injury&nbsp; was detected on ultrasound .&nbsp; In light of&nbsp; h/o abdominal injury&nbsp; ,&nbsp; a diagnosis of&nbsp; jejunal loop hematoma was suggested&nbsp; , which was confirmed at surgery&nbsp; ;&nbsp; isolated jejunal &nbsp;hematoma [ see fig- 3].<b> Case submitted by&nbsp;<o:p></o:p></b></span><span style="font-family: Arial, sans-serif; font-size: 16px; line-height: 18px;"><b>Dr. Subhash Tailor, MD, Bhilwara [ Rajasthan , India]</b></span></div><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 16px; line-height: 18px;"><b><br /></b></span></div><div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-euCT_mHI4f0/UijfkkJgJ0I/AAAAAAAAFgU/9ohy75AUZrs/s1600/Picture1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="228" src="http://4.bp.blogspot.com/-euCT_mHI4f0/UijfkkJgJ0I/AAAAAAAAFgU/9ohy75AUZrs/s320/Picture1.jpg" width="320" /></a></div><div class="MsoNormal" style="text-align: justify;"><br /></div><div class="MsoNormal" style="text-align: justify;"><span lang="EN-IN" style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 12.0pt; line-height: 115%;"><b>Fig 1 -&nbsp;&nbsp; Left paraumbilical&nbsp; transverse USG &nbsp;image shows a well defined hypoechoic mass along jejunal &nbsp;bowel loop making&nbsp; exophytic bulge .</b><o:p></o:p></span></div><div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-MOGmB-fMaJs/Uijfk6Xm3ZI/AAAAAAAAFgo/5BhLT-4sZis/s1600/Picture2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="208" src="http://3.bp.blogspot.com/-MOGmB-fMaJs/Uijfk6Xm3ZI/AAAAAAAAFgo/5BhLT-4sZis/s320/Picture2.jpg" width="320" /></a></div><div class="MsoNormal" style="text-align: justify;"><br /></div><div class="MsoNormal" style="text-align: justify;"><span lang="EN-IN" style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 12.0pt; line-height: 115%;"><b>Fig 2 -&nbsp; Obliquely longitudinal USG &nbsp;scan shows the same mass along jejunal loop compressing the lumina. The mass was vascular on color Doppler.</b><o:p></o:p></span></div><div class="MsoNormal" style="text-align: justify;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-wbaZjTGXQ4c/UijfkvmGqJI/AAAAAAAAFgk/_C5FfcAxqW0/s1600/Picture3.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="225" src="http://3.bp.blogspot.com/-wbaZjTGXQ4c/UijfkvmGqJI/AAAAAAAAFgk/_C5FfcAxqW0/s320/Picture3.jpg" width="320" /></a></div><div class="MsoNormal" style="text-align: justify;"><span lang="EN-IN" style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 12.0pt; line-height: 115%;"><br /></span></div><div class="MsoNormal" style="text-align: justify;"><span lang="EN-IN" style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 12.0pt; line-height: 115%;"><b>Fig 3 – Per operative photograph revealing isolated segmental jejunal &nbsp;wall hematoma.<o:p></o:p></b></span></div><br /><div class="MsoNormal" style="text-align: justify;"><span lang="EN-IN" style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 12.0pt; line-height: 115%;"><b>[ Operative&nbsp; photograph courtesy ; Dr. Gaurav Bahety M.Ch., Bhilwara ]</b><o:p></o:p></span></div></div><div class="blogger-post-footer">From Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine. Teleradiology Providers at www.teleradproviders.com Mail us at sales@teleradproviders.com</div><br> 2013 2013 2013 <br><div dir="ltr" style="text-align: left;" trbidi="on"><div class="MsoNormal" style="text-align: justify;"><span lang="EN-IN" style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 115%;">A 6 yrs old female child with h/o &nbsp;blunt abdominal trauma 3 days back, episode of malena, &amp;&nbsp; having pain abdomen,&nbsp; was referred for ultrasound evaluation &nbsp;of abdomen .&nbsp; At USG&nbsp; a well defined hypoechoic&nbsp; oval mass was seen along jejunal&nbsp; bowel loop,&nbsp; likely involving its wall, with slight exophytic bulge , &amp; focally distorting gut signature [ fig 1 &amp; 2] . The mass&nbsp; did not reveal internal vascularity on Doppler.&nbsp; The affected segment of jejunum&nbsp; was sluggishly motile , &amp;&nbsp; showed mild luminal narrowing&nbsp; with&nbsp; proximal fullness.&nbsp; Surprisingly no any other evidence of intraabdominal free fluid , mesenteric mass or fluid ,or solid visceral injury&nbsp; was detected on ultrasound .&nbsp; In light of&nbsp; h/o abdominal injury&nbsp; ,&nbsp; a diagnosis of&nbsp; jejunal loop hematoma was suggested&nbsp; , which was confirmed at surgery&nbsp; ;&nbsp; isolated jejunal &nbsp;hematoma [ see fig- 3].<b> Case submitted by&nbsp;<o:p></o:p></b></span><span style="font-family: Arial, sans-serif; font-size: 16px; line-height: 18px;"><b>Dr. Subhash Tailor, MD, Bhilwara [ Rajasthan , India]</b></span></div><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 16px; line-height: 18px;"><b><br /></b></span></div><div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-euCT_mHI4f0/UijfkkJgJ0I/AAAAAAAAFgU/9ohy75AUZrs/s1600/Picture1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="228" src="http://4.bp.blogspot.com/-euCT_mHI4f0/UijfkkJgJ0I/AAAAAAAAFgU/9ohy75AUZrs/s320/Picture1.jpg" width="320" /></a></div><div class="MsoNormal" style="text-align: justify;"><br /></div><div class="MsoNormal" style="text-align: justify;"><span lang="EN-IN" style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 12.0pt; line-height: 115%;"><b>Fig 1 -&nbsp;&nbsp; Left paraumbilical&nbsp; transverse USG &nbsp;image shows a well defined hypoechoic mass along jejunal &nbsp;bowel loop making&nbsp; exophytic bulge .</b><o:p></o:p></span></div><div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-MOGmB-fMaJs/Uijfk6Xm3ZI/AAAAAAAAFgo/5BhLT-4sZis/s1600/Picture2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="208" src="http://3.bp.blogspot.com/-MOGmB-fMaJs/Uijfk6Xm3ZI/AAAAAAAAFgo/5BhLT-4sZis/s320/Picture2.jpg" width="320" /></a></div><div class="MsoNormal" style="text-align: justify;"><br /></div><div class="MsoNormal" style="text-align: justify;"><span lang="EN-IN" style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 12.0pt; line-height: 115%;"><b>Fig 2 -&nbsp; Obliquely longitudinal USG &nbsp;scan shows the same mass along jejunal loop compressing the lumina. The mass was vascular on color Doppler.</b><o:p></o:p></span></div><div class="MsoNormal" style="text-align: justify;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-wbaZjTGXQ4c/UijfkvmGqJI/AAAAAAAAFgk/_C5FfcAxqW0/s1600/Picture3.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="225" src="http://3.bp.blogspot.com/-wbaZjTGXQ4c/UijfkvmGqJI/AAAAAAAAFgk/_C5FfcAxqW0/s320/Picture3.jpg" width="320" /></a></div><div class="MsoNormal" style="text-align: justify;"><span lang="EN-IN" style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 12.0pt; line-height: 115%;"><br /></span></div><div class="MsoNormal" style="text-align: justify;"><span lang="EN-IN" style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 12.0pt; line-height: 115%;"><b>Fig 3 – Per operative photograph revealing isolated segmental jejunal &nbsp;wall hematoma.<o:p></o:p></b></span></div><br /><div class="MsoNormal" style="text-align: justify;"><span lang="EN-IN" style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 12.0pt; line-height: 115%;"><b>[ Operative&nbsp; photograph courtesy ; Dr. Gaurav Bahety M.Ch., Bhilwara ]</b><o:p></o:p></span></div></div><div class="blogger-post-footer">From Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine. Teleradiology Providers at www.teleradproviders.com Mail us at sales@teleradproviders.com</div><br>2013 2013 2013 <br> <a href="http://www.matrixar.com/" title="Matrix ">المصفوفة : أجمل الخلفيات والصور</a>

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