16 year old chow cross presented for acutely painful abdomen and increasingly bloated appearance to abdomen.
-The left adrenal appears normal in shape and measures 0.88cm.
-A mid-body splenic mass is present.
-Several hyperehcoic liver nodules are present.
16 year old chow cross presented for acutely painful abdomen and increasingly bloated appearance to abdomen.
-The left adrenal appears normal in shape and measures 0.88cm.
-A mid-body splenic mass is present.
-Several hyperehcoic liver nodules are present.
I think this is probably a right adrenal mass with evidence of a resolving hematoma (retroperitoneal?) from a bleed. The large hypoechoic cavity with the lacy appearance does not take up color. I initially thought this was likely a pancreatic pseudocyst but I think that’s a bit less likely now. I got a sample from the hypoechoic area and appeared to only get blood contamination but it was semi-solid and I was only able to aspirate a small amount of fluid that appeared grossly to be blood.
However, I did have some difficulty with the interpretation of these images with the proximity to the pancreas and want to make sure this is the likely origin of the pain.
Thanks!
Suzanne
Please ignore the label on the 3rd clip.
Comments
Beautiful images. All the
Beautiful images. All the fuzzy fat is consistent with inflammation and the hypoechoic regions blood or clots or exapasnion of the cvc. The adrenal mass is within the cvc in the bottom of the last clip. Pheo or adenoca. Much of the anechoic fluid is slow blood backup within the cvc and some free fluid in the abdomen as well. The cvc dilated wickedly owing to the cork position of the right adrenal mass. ugly pathology. nice post
Thanks – very helpful! It
Thanks – very helpful! It occurred to me late last night that I may have been sampling the CVC – I’m glad there were no apparent consequences and I didn’t think about it at the time! He’s 16 so I’m not sure that surgery is in his future.
Suzanne
Beautiful images. All the
Beautiful images. All the fuzzy fat is consistent with inflammation and the hypoechoic regions blood or clots or exapasnion of the cvc. The adrenal mass is within the cvc in the bottom of the last clip. Pheo or adenoca. Much of the anechoic fluid is slow blood backup within the cvc and some free fluid in the abdomen as well. The cvc dilated wickedly owing to the cork position of the right adrenal mass. ugly pathology. nice post
Thanks – very helpful! It
Thanks – very helpful! It occurred to me late last night that I may have been sampling the CVC – I’m glad there were no apparent consequences and I didn’t think about it at the time! He’s 16 so I’m not sure that surgery is in his future.
Suzanne