![card image](../uploads/223/70/6645d46c_151a22e0018__8000_00009441.jpg)
Courvoisier's GB
Distension without wall thickening
due to obstruction distal to the cystic duct
*Panncreatic head mass
* Duodenal papilla mass
*CBD mass
![card image](../uploads/224/71/6645d46c_151a22e0018__8000_00009443.jpg)
RUQ pain
Jaundice
recurrent cholangitis
Mirizzi SYndrome
impacted stone in the cystic duct or GB neck
presence of two tubular structures representing the bile duct above the level of the cystic duct
![card image](../uploads/225/72/6645d46c_151a22e0018__8000_00009445.jpg)
Mirizzi SYndrome
impacted stone in the cystic duct or GB neck
presence of two tubular structures representing the bile duct above the level of the cystic duct
![card image](../uploads/226/73/6645d46c_151a22e0018__8000_00009447.jpg)
Patient has been fed intravenously for 3 days.
Sludge
highly concentrated bile
![card image](../uploads/227/74/6645d46c_151a22e0018__8000_00009449.jpg)
Gravity dependent
Cholelithiasis
Mobile, hyperechoic, round or triangular structures casting a well defined posterior acoustic shadowing
Will change when patient’s body position changes (Gravity dependent)
![card image](../uploads/228/75/6645d46c_151a22e0018__8000_00009451.jpg)
RUQ pain
fever
leukocytosis
Positive Murphy's sign
Acute cholecystitis
inflamation of the GB wall w/ stone
![card image](../uploads/229/76/6645d46c_151a22e0018__8000_00009461.jpg)
Diabetic
RUQ pain
fever
leukocytosis
Emphysematous Cholecystitis
Gas forming bacteria in gallbladder wall yields to high intensity echoes and comet tail artifact
![card image](../uploads/768/21/6645d46c_151a22e0018__8000_00010852.jpg)
RUQ pain
fever
leukocytosis
Empyema of the gallbladder
![card image](../uploads/919/73/6645d46c_151a22e0018__8000_00011237.jpg)
Perforation in the gallbladder wall
![card image](../uploads/230/77/6645d46c_151a22e0018__8000_00009453.jpg)
Typically secondary event in critically ill
Acalculus Cholecystitis
Inflammation of GB wall without stones
![card image](../uploads/231/78/6645d46c_151a22e0018__8000_00009455.jpg)
Chronic Cholecystitis
Contracted gallbladder with acoustic shadowing from cholelithiasis
Thick hyperechoic gallbladder wall greater than 4 – 5 mm
Sludge may be present
![card image](../uploads/769/22/6645d46c_151a22e0018__8000_00010859.jpg)
patient present with chronic Cholecytitis
Milk of calcium Bile (Limy bile)
![card image](../uploads/232/79/6645d46c_151a22e0018__8000_00009457.jpg)
Asymptomatic with palpable RUQ mass
Hydrops GB
Greater than 4cm in diameter
![card image](../uploads/233/80/6645d46c_151a22e0018__8000_00009459.jpg)
Female patient with Chronic Cholecystitis
Porcelain GB
Calcification of GB wall due to chronic cholecytitis
![card image](../uploads/234/81/6645d46c_151a22e0018__8000_00009465.jpg)
Gangrenous Cholecystitis
![card image](../uploads/235/82/6645d46c_151a22e0018__8000_00009467.jpg)
GB Ademoma
epithelial tumor
overgrowth of the lining
![card image](../uploads/236/83/6645d46c_151a22e0018__8000_00009469.png)
GB Ademoma
epithelial tumor
overgrowth of the lining
![card image](../uploads/237/84/6645d46c_151a22e0018__8000_00009471.jpg)
Asymptomatic
Gallbladder Adenomyomatosis
diverticulum of the GB
Focal, segmental or diffuse smooth muscle proliferation with exaggerated diverticular appearance of the Rokitansky – Aschoff sinuses into the muscular wall
![card image](../uploads/238/85/6645d46c_151a22e0018__8000_00009473.jpg)
Gallbladder Cholesterolosis
Non shadowing, hyperechoic, polyp
Strawberry GB
Lipids
![card image](../uploads/239/86/6645d46c_151a22e0018__8000_00009475.jpg)
60 year old with long standing cholecystitis
and porcelain GB
Gallbladder Carcinoma
Most commonly a mass from the gallbladder fossa replaces the gallbladder and invades adjacent liver.
Focal or diffuse irregular gallbladder wall thickening
Polypoid intramural lesions with irregular borders
![card image](../uploads/240/87/6645d46c_151a22e0018__8000_00009477.jpg)
Stage 4 colon cancer
Gallbladder Metastasis
commonly from stomach, pancreas and bile ducts
![card image](../uploads/241/88/6645d46c_151a22e0018__8000_00009479.jpg)
RUQ pain
Jaundice
Elevated Alkaline phosphatase
Elevated conjugated bilirubin
Elevated Gamma gluamyl transpeptidase
Choledocholithiasis
obstrution by biliary stone
![card image](../uploads/242/89/6645d46c_151a22e0018__8000_00009481.jpg)
RUQ pain
Fever
Jaundice
Elevated Conjugated bilirubin
Elevated Alkaline phosphatase ALP
Elevated GGT
Elevated amylase and lipase
Elevated white blood count
Cholangitis
inflamation of the duct walls
![card image](../uploads/243/90/6645d46c_151a22e0018__8000_00009483.jpg)
asymptomatic
biliary colic
cholangitis
Poor hygiene
Ascariasis
infection of round worms
![card image](../uploads/244/91/6645d46c_151a22e0018__8000_00009489.jpg)
asymptomatic
biliary colic
cholangitis
Poor hygiene
Ascariasis
infection of round worms
![card image](../uploads/245/92/6645d46c_151a22e0018__8000_00009485.jpg)
Pain
Hematemesis
caused by procedures or biopsy
Hemobilia
blood in the biliary tree
caused by procedures or biopsy
![card image](../uploads/246/93/6645d46c_151a22e0018__8000_00009487.jpg)
Patient recently had ERCP
pneumobilia
Air within the biliary tree
![card image](../uploads/247/94/6645d46c_151a22e0018__8000_00009491.jpg)
Jaundice
weight loss
abdominal pain
Cholangiocarcinoma
typically originate within the extrahepatic bile ducts
![card image](../uploads/248/95/6645d46c_151a22e0018__8000_00009493.jpg)
Neonate presents with Jaundice for 14+ days
Biliary Atresia
Congenital
cystic formation without dilated interhepatic ducts
![card image](../uploads/249/96/6645d46c_151a22e0018__8000_00009495.jpg)
congenital hepatic fibrosis
Portal hypertension
Caroli's Disease
congenital cystic dilatation of the intrahepatic biliary tree
![card image](../uploads/250/97/6645d46c_151a22e0018__8000_00009497.jpg)
9 year old Japanese patient
Choledochal Cyst
Congenital cystic dilation of the extrahpatic biliary tree
![card image](../uploads/251/98/6645d46c_151a22e0018__8000_00009499.jpg)
Klatskin Tumor
malignant tumor arising between the left and right hepatic ducts
![card image](../uploads/837/90/6645d46c_151a22e0018__8000_00011046.jpg)
Patient in Great Lakes basin
Liver granulomas
![card image](../uploads/253/1/6645d46c_151a22e0018__8000_00009503.jpg)
Hypoechoic renal cortex
obese
Type II diabetes
Fatty infiltration
![card image](../uploads/254/2/6645d46c_151a22e0018__8000_00009509.jpg)
Fat Sparing
![card image](../uploads/255/3/6645d46c_151a22e0018__8000_00009507.jpg)
- diabetes mellitus
- obesity
- alcohol abuse
- exogenous steroids
- drugs (amiodarone, methotrexate, chemotherapy)
- IV hyperalimentation
focal fatty infiltration
![card image](../uploads/256/4/6645d46c_151a22e0018__8000_00009511.jpg)
Infant
impaired growth
hypoglycemia
CHF
delayed puberty
osteoporosis
Glycogen Storage Disease
Autosomal recessive disorder of carb metabolism
found in infants
seen with adenomas
![card image](../uploads/257/5/6645d46c_151a22e0018__8000_00009513.jpg)
Elevated
ALT
AST
Bilirubin con & un
Acute Hepatitis
Generally normal
but can have portal cuffing (starry sky)
![card image](../uploads/258/6/6645d46c_151a22e0018__8000_00009515.jpg)
Elevated
ALT
AST
Bilirubin con & un
Chronic Hepatitis
course texture
increased echogenicity
![card image](../uploads/259/7/6645d46c_151a22e0018__8000_00009517.jpg)
chronic hepatitis
alcoholism
elevated
AST
ALT
GGT
LDH
conjugated bilirubin
Cirrhosis
nodular and course
heterogenic
Ascites
![card image](../uploads/260/8/6645d46c_151a22e0018__8000_00009519.jpg)
Cirrhosis
nodular and course
heterogenic
Ascites
![card image](../uploads/261/9/6645d46c_151a22e0018__8000_00009521.jpg)
asymptomatic
sudden painless upper GI hemorrhage due to ruptures esophageal varices
Portal Hypertension
![card image](../uploads/262/10/6645d46c_151a22e0018__8000_00009523.jpg)
Portal Hypertension
![card image](../uploads/263/11/6645d46c_151a22e0018__8000_00009525.jpg)
Budd-Chiari
Life threatening emergency
![card image](../uploads/264/12/6645d46c_151a22e0018__8000_00009527.jpg)
Portal vein Thrombosis - cavernous transformation
replacement of the normal single channel portal vein with numerous tortuous venous channels.
![card image](../uploads/265/13/6645d46c_151a22e0018__8000_00009531.jpg)
50+
Cysts
True cysts are congenital
other cysts lack an epithelial lining and are not true cysts
![card image](../uploads/266/14/6645d46c_151a22e0018__8000_00009533.jpg)
Presentation
Fever
pain
N&V
Leukocytosis
Elevated LFTs
Pyogenic (bacterial) abscess
![card image](../uploads/267/15/6645d46c_151a22e0018__8000_00009535.jpg)
Presentation
fever
pain
diarrhea
Leukocytosis
Elevated LFTs
Amebic abscess
contaminated food or water usually in colon but can invade the liver through the portal vein
fever
pain
diarrhea
![card image](../uploads/268/16/6645d46c_151a22e0018__8000_00009537.jpg)
May also present
wheel within a wheel
Bull's eye
Echogenic focus
Candidiasis
early wheel within wheel
later hypoechoic
![card image](../uploads/269/17/6645d46c_151a22e0018__8000_00009545.jpg)
# cause of portal hypertension
Schistosomiasis
#1 cause of portal hypertension in the world. Not common in US but estimated 400,000 infected people have immigrated
parasitic infection mainly in Egypt
- irregular surface of liver
- hyperechoic thickened walls of portal venules giving the "clay-pipestem" pattern of periportal fibrosis
- marked thickening and echogenecity of the gallbladder bed
- splenomegaly
- portal vein and splenic vein dilatation with maintained continuous hepatopetal flow and average velocity
![card image](../uploads/270/18/6645d46c_151a22e0018__8000_00009539.jpg)
Sheep herder
Echinococcal Cyst
Sheep Herders
AKA Hydatid Cyst
![card image](../uploads/271/19/6645d46c_151a22e0018__8000_00009541.png)
Sheep herder
Echinococcal Cyst
Sheep Herders
AKA Hydatid Cyst
![card image](../uploads/272/20/6645d46c_151a22e0018__8000_00009543.jpg)
Water lily
Sheep herder
Echinococcal Cyst
Sheep Herders
AKA Hydatid Cyst
![card image](../uploads/273/21/6645d46c_151a22e0018__8000_00009551.jpg)
24 year old female on birth control pills
Pain
Liver Adenoma
Females taking birth control
*Hypoechoic
*Hyperechoic
*Isoechoic
*Mixed
![card image](../uploads/274/22/6645d46c_151a22e0018__8000_00009549.jpg)
enlarge with pregnancy
Cavernous Hemangioma
![card image](../uploads/920/74/6645d46c_151a22e0018__8000_00011239.jpg)
Hepatic lipoma
![card image](../uploads/275/23/6645d46c_151a22e0018__8000_00009553.jpg)
Asymptomatic
Focal Nodular Hyperplasia
abnormally arranged hepatocytes
Second most common benign liver mass
![card image](../uploads/277/25/6645d46c_151a22e0018__8000_00009557.jpg)
6 month old female
abdominal mass
CHF
Hemangioendothelioma
Benign condition of overgrowth of endothelium of capillaries
Found in infants
Usually seen as hepatic lesions that are predominantly hypoechoic; however, hepatic lesions can also have mixed echotexture or be predominantly hyperechoic.
![card image](../uploads/278/26/6645d46c_151a22e0018__8000_00009559.jpg)
Two year old with palpable mass on right side
Mesenchymal hamartoma
rare developmental cystic tumor of the lover
complex mass
more common in rt lobe
![card image](../uploads/279/27/6645d46c_151a22e0018__8000_00009561.jpg)
3 year old
abdominal enlargement
weight loss
nausea and vomiting
marked elevation of AFP
Hepatoblastoma
malignant germ cell tumor
most common malignant liver tumor of children under 3
associated with Beckwith Wiedermann
![card image](../uploads/280/28/6645d46c_151a22e0018__8000_00009563.jpg)
Patient with cirrhosis
Hepatocellular Carcinoma
solid
multiple
diffuse
![card image](../uploads/281/29/6645d46c_151a22e0018__8000_00009565.jpg)
Hemangiosarcoma
rare in 60 - 80
related to exposure of thorotrast, arsenic or polyvinyl chloride
large mixed mass
![card image](../uploads/282/30/6645d46c_151a22e0018__8000_00009567.png)
Liver mets from ?
Metastasis to the liver
colon
Most common
![card image](../uploads/283/31/6645d46c_151a22e0018__8000_00009571.jpg)
Liver mets from ?
Metastasis to the liver
Breast
![card image](../uploads/284/32/6645d46c_151a22e0018__8000_00009573.jpg)
Liver mets from ?
Metastasis to the liver
Lung
![card image](../uploads/285/33/6645d46c_151a22e0018__8000_00009575.jpg)
Liver mets from ?
Lymphoma
![card image](../uploads/286/34/6645d46c_151a22e0018__8000_00009577.jpg)
Pain
hypertension
after car accident
Liver hematoma
![card image](../uploads/287/35/6645d46c_151a22e0018__8000_00009579.jpg)
Annular Pancreas
![card image](../uploads/288/36/6645d46c_151a22e0018__8000_00009581.jpg)
6 year old present
Cystic Fibrosis
autosomal Recessive
Pancreas appears hyperechoic due to microcystic changes, increased fibrotic and fat
![card image](../uploads/289/37/6645d46c_151a22e0018__8000_00009583.jpg)
severe constant, intense pain radiating to the back
N & V
fever
sweating
paralytic ilius
elevated amylase 48 - 78 hours
elevated lipase 5 - 7 days
WBC
Acute Pancreatitis
![card image](../uploads/290/38/6645d46c_151a22e0018__8000_00009585.jpg)
severe constant, intense pain radiating to the back
N & V
fever
sweating
paralytic ilius
elevated amylase 48 - 78 hours
decreased hematocrit & calcium
Hemorrhagic Pancreatitis
Type of acute pancreatitis 2% to 5%
significant fat necrosis that results in rupture of pancreatic vessels and secondary hemorrhage
![card image](../uploads/291/39/6645d46c_151a22e0018__8000_00009587.jpg)
N & V
fever
sweating
paralytic ilius
elevated amylase 48 - 78 hours
elevated lipase 5 - 7 days
WBC
Phlegmonous Pancreatitis
Type of acute pancreatitis 18%
enlarged solid inflammatory mass with retroperitoneal fat necrosis
usually lesser sac is involved
![card image](../uploads/292/40/6645d46c_151a22e0018__8000_00009589.jpg)
Pancreatic Abscess
infection of necrotic pancreatic and retroperitoneal fat
![card image](../uploads/293/41/6645d46c_151a22e0018__8000_00009591.jpg)
persistently elevated amylase and lipase
Pancreatic Psydocyst
Spherical fluid collection of pancreatic enzymes that arise from inflamatory, necrotic and hemorrhage processes of the pancrreas
![card image](../uploads/294/42/6645d46c_151a22e0018__8000_00009593.jpg)
persistently elevated amylase and lipase
Pancreatic Psydocyst
Spherical fluid collection of pancreatic enzymes that arise from inflamatory, necrotic and hemorrhage processes of the pancrreas
![card image](../uploads/295/43/6645d46c_151a22e0018__8000_00009595.jpg)
persistently elevated amylase and lipase
Pancreatic Psydocyst
Spherical fluid collection of pancreatic enzymes that arise from inflamatory, necrotic and hemorrhage processes of the pancrreas
![card image](../uploads/296/44/6645d46c_151a22e0018__8000_00009597.jpg)
N & V
flatulence
weight loss
Chronic Pancreatitis
Ongoing inflammation that results in permanent damage
![card image](../uploads/297/45/6645d46c_151a22e0018__8000_00009599.jpg)
N & V
flatulence
weight loss
Chronic Pancreatitis
Ongoing inflammation that results in permanent damage
![card image](../uploads/298/46/6645d46c_151a22e0018__8000_00009601.jpg)
Mid epigastric Pain
weight loss
jaundice
palpable mass
Cystadenoma
multiple cystic masses that contain secreted material
![card image](../uploads/299/47/6645d46c_151a22e0018__8000_00009603.jpg)
Mid epigastric Pain
weight loss
jaundice
palpable mass
Mucinous Cystic / Cystadenocarcinoma
malignant tumor from glandular tissue in which secretions are oobtained
![card image](../uploads/300/48/6645d46c_151a22e0018__8000_00009605.jpg)
25 year old female with vague abdominal pain
Serious Cystadenoma / Microcystic adenoma
type of serous cystadenoma
lobulated mass of numerous small cysts
![card image](../uploads/301/49/6645d46c_151a22e0018__8000_00009607.jpg)
Most common cause of malignant neoplasm
abdominal / back pain
jaundice
weight loss
Adenocarcinoma
arises from the epithelium and involves the exocrine portion of the pancreas
![card image](../uploads/411/60/6645d46c_151a22e0018__8000_00009864.jpg)
The most common form of fusion anomaly of the kidneys
Horseshoe Kidneys
![card image](../uploads/412/61/6645d46c_151a22e0018__8000_00009866.jpg)
The most common form of fusion anomaly of the kidneys
Horseshoe Kidneys
![card image](../uploads/413/62/6645d46c_151a22e0018__8000_00009868.jpg)
Crossed fused Renal Ectopia
![card image](../uploads/414/63/6645d46c_151a22e0018__8000_00009870.jpg)
Right kidney
Junctional Parenchymal Defect
![card image](../uploads/415/64/6645d46c_151a22e0018__8000_00009872.jpg)
often seen with hydronephrosis in the upper pole
Duplex Kidney
Seen in 15% of population
![card image](../uploads/416/65/6645d46c_151a22e0018__8000_00009874.jpg)
Duplex Kidney
![card image](../uploads/417/66/6645d46c_151a22e0018__8000_00009880.png)
Extrarenal Pelvis
![card image](../uploads/418/67/6645d46c_151a22e0018__8000_00009886.gif)
Male neonate
Posterior Urethral valves
![card image](../uploads/419/68/6645d46c_151a22e0018__8000_00009888.jpg)
30 year old male presents for a renal ultrasound
liver & spleen cysts
Adult Polycystic Kidney Disease
![card image](../uploads/420/69/6645d46c_151a22e0018__8000_00009890.jpg)
infant presents with renal dysfunction
Infantile Polycystic Kidney Disease
results from cystic dilation of the collecting tubules
![card image](../uploads/421/70/6645d46c_151a22e0018__8000_00009892.jpg)
Most common cause of abdominal mass in newborns
unilateral
Multicystic Dysplastic Kidney
![card image](../uploads/422/71/6645d46c_151a22e0018__8000_00009898.jpg)
chronic renal failure
hemodialysis
Aquired Cystic Disease
multiple cysts in failing kidney during long term hemodialysis
hemorrhage often occurs
![card image](../uploads/423/72/6645d46c_151a22e0018__8000_00009912.jpg)
Medullary Sponge Kidney
congenital dysplastic dilatation of the medullary pyramids due to tubular ectasia or dysplasia
medullary neprocalcinosis
![card image](../uploads/424/73/6645d46c_151a22e0018__8000_00009914.jpg)
medullary neprocalcinosis
![card image](../uploads/441/90/6645d46c_151a22e0018__8000_00009956.jpg)
hypercalcemia
hypercalciuria
Nephrocalcinosis
20 year old presents with visual impairments
Von Hippel-Lindau Disease
inhearited usually present in 2nd to 3rd decade
![card image](../uploads/425/74/6645d46c_151a22e0018__8000_00009918.jpg)
right kidney
Angiomyolipoma
benign fatter renal tumor
80% involve right kidney
echogenicity is gretr than of equal to the renal sinus
![card image](../uploads/426/75/6645d46c_151a22e0018__8000_00009922.jpg)
right kidney
Angiomyolipoma
benign fatter renal tumor
80% involve right kidney
echogenicity is gretr than of equal to the renal sinus
![card image](../uploads/427/76/6645d46c_151a22e0018__8000_00009926.jpg)
seizures
mental retardation
facial angiofibroma
bilateral Angiomyolipomas
Tuberous Sclerosis
genetic
![card image](../uploads/428/77/6645d46c_151a22e0018__8000_00009930.jpg)
Most common solid renal mass in adults
hematuria
flank pain
palpable mass
lung mets
Renal Cell Carcinoma
![card image](../uploads/429/78/6645d46c_151a22e0018__8000_00009932.jpg)
Most common solid renal mass in adults
hematuria
flank pain
palpable mass
lung mets
Renal Cell Carcinoma
![card image](../uploads/430/79/6645d46c_151a22e0018__8000_00009934.jpg)
generally appear as hypoechoic or diffuse enlargement
Renal Metastases
![card image](../uploads/431/80/6645d46c_151a22e0018__8000_00009936.jpg)
3 years
large asymptomatic flank amss
hypertension
fever
hematuria
Wilm's Tumor
3 years
90% survival
![card image](../uploads/432/81/6645d46c_151a22e0018__8000_00009938.jpg)
Acute Pyelonephritis
travel from bladder
AKA acute focal bateria nephritis / lobar nephritis
![card image](../uploads/440/89/6645d46c_151a22e0018__8000_00009950.jpg)
Acute Pyelonephritis
travel from bladder
AKA acute focal bateria nephritis / lobar nephritis
![card image](../uploads/433/82/6645d46c_151a22e0018__8000_00009940.jpg)
diabetic
Emphysematous pyelonephritis
Gas in the kidney
nephroectomy is usually required
small hyperechoic kidneys with cortical thinning
Chronic Pyelonephritis
due to recurrent renal infection
![card image](../uploads/434/83/6645d46c_151a22e0018__8000_00009942.jpg)
type of Chronic Pyelonephritis
Xanthogranulomatous Pyelonephritis XGPN
Chronic Pyelonephritis due to stone
![card image](../uploads/435/84/6645d46c_151a22e0018__8000_00009944.gif)
type of Chronic Pyelonephritis
Xanthogranulomatous Pyelonephritis XGPN
Chronic Pyelonephritis due to stone
![card image](../uploads/436/85/6645d46c_151a22e0018__8000_00009946.jpg)
due to secondary infection from renal obstrution
Pyonephrosis
![card image](../uploads/437/86/6645d46c_151a22e0018__8000_00009948.jpg)
Mycetoma (fungal ball)
candidiasis is the most common
Non shadowing hyperechoic mass
![card image](../uploads/438/87/6645d46c_151a22e0018__8000_00009952.jpg)
Most common cause of acute renal failure
prolonged drugs or contrast agents
Acute Tubular Necrosis (ATN)
![card image](../uploads/439/88/6645d46c_151a22e0018__8000_00009954.jpg)
hematuria
proteinuria
azotemia
red blood cell casts in urine
Acute Glomerulonephritis
gomerular damage
caused by
autoimmune
infection
toxins
![card image](../uploads/442/91/6645d46c_151a22e0018__8000_00009958.jpg)
anagesic abuse
diabetes mellitus
UTI and obstruction
sickle cell
CHF
Papillary Necrosis
![card image](../uploads/443/92/6645d46c_151a22e0018__8000_00009960.jpg)
Renal Sinus Lipomatosis
![card image](../uploads/476/26/6645d46c_151a22e0018__8000_00009962.jpg)
benign prostatic hypertrophy
Bladder diverticula
![card image](../uploads/477/27/6645d46c_151a22e0018__8000_00009964.jpg)
Urachal Cyst
![card image](../uploads/478/28/6645d46c_151a22e0018__8000_00009966.jpg)
Ureteroceles
![card image](../uploads/479/29/6645d46c_151a22e0018__8000_00009968.jpg)
Most common bladder neoplasm
hematuria
hydronephrosis
Transitional Cell Carcinoma
![card image](../uploads/480/30/6645d46c_151a22e0018__8000_00009970.jpg)
Most common bladder neoplasm
hematuria
hydronephrosis
Transitional Cell Carcinoma
![card image](../uploads/481/31/6645d46c_151a22e0018__8000_00009972.jpg)
Lymphocele
![card image](../uploads/482/32/6645d46c_151a22e0018__8000_00009974.jpg)
most common germ cell tumor
white male smoker
infertility
Seminoma
![card image](../uploads/483/33/6645d46c_151a22e0018__8000_00009976.jpg)
25 - 35 year olds
most aggressive testicular cancer
elevated beta-hcg
elevated AFp
Embryonal Cell carcinoma
![card image](../uploads/484/34/6645d46c_151a22e0018__8000_00009978.jpg)
common in infants
25 - 35 year olds
Testicular Teratoma
![card image](../uploads/485/35/6645d46c_151a22e0018__8000_00009980.jpg)
most common testicular tumor in infants and young children
elevated afp
Yolk sac tumors
![card image](../uploads/486/36/6645d46c_151a22e0018__8000_00009982.jpg)
20 - 30 year old
elevated beta-Hcg
Choriocarcinoma
![card image](../uploads/487/37/6645d46c_151a22e0018__8000_00009984.png)
5-10 year old - benign
precocious puberty
feminizing features (gynecomastia)
Leydig Cell tumors
![card image](../uploads/488/38/6645d46c_151a22e0018__8000_00009990.jpg)
appears in 10% of population
Epidermoid Cysts
benign testicular cyst
![card image](../uploads/489/39/6645d46c_151a22e0018__8000_00009992.jpg)
fever
scrotal pain
swelling
untreated orchitis
Testicular abscess
co
![card image](../uploads/490/40/6645d46c_151a22e0018__8000_00009994.jpg)
Testiular Pearls
testicular calcification
![card image](../uploads/491/41/6645d46c_151a22e0018__8000_00009996.jpg)
40% have neoplasm asscoiation
Microlithiasis
![card image](../uploads/492/42/6645d46c_151a22e0018__8000_00009998.jpg)
trauma
torsion
Testicular infarct
![card image](../uploads/921/75/6645d46c_151a22e0018__8000_00011241.jpg)
trauma
pain
scrotal Hematocele
![card image](../uploads/922/76/6645d46c_151a22e0018__8000_00011243.jpg)
trauma
pain
swelling
fever
leukocytosis
scrotal pyocele
![card image](../uploads/493/43/6645d46c_151a22e0018__8000_00010000.jpg)
most common fluid collection of the testicle
Hydrocele
serious fluid between the tunica vaginalis
![card image](../uploads/494/44/6645d46c_151a22e0018__8000_00010002.jpg)
left side
most common correctible cause of male infertility
Varicocele
![card image](../uploads/495/45/6645d46c_151a22e0018__8000_00010004.jpg)
left side
most common correctible cause of male infertility
Varicocele
![card image](../uploads/496/46/6645d46c_151a22e0018__8000_00010006.jpg)
swollen scrotum
persistent or intermittent palpable mass
abdominal pain
blood in stool
Scrotal Hernia
![card image](../uploads/497/47/6645d46c_151a22e0018__8000_00010008.jpg)
most common extratesticular tumor
adenomatoid tumor
![card image](../uploads/498/48/6645d46c_151a22e0018__8000_00010010.jpg)
Spermatoceles
AKA Epididymal Cysts
result of dilation of the epididymal tubules
![card image](../uploads/499/49/6645d46c_151a22e0018__8000_00010012.jpg)
most common condition that causes scrotal pain
possible fever
pyuria
STD
UTI
Epididymitis
inflammation of epididymis usually due to UTI
![card image](../uploads/500/50/6645d46c_151a22e0018__8000_00010014.jpg)
pain usually during rest or sleep
N & V
torsion
less than 6 hours 80% + salvage
6 - 12 hours 70% salvage
12 + hours :(
![card image](../uploads/501/51/6645d46c_151a22e0018__8000_00010018.jpg)
most common cause of mender 35 is chlamidia
pain
elevated WBC
Orchitis
![card image](../uploads/502/52/6645d46c_151a22e0018__8000_00010020.jpg)
50+ year old man
difficult voiding
urinary frequency
small stream
Benign Prostatic Hyperplasia
usually in transitional zones
![card image](../uploads/503/53/6645d46c_151a22e0018__8000_00010024.jpg)
Mullerian Duct Cyst
usually midline
![card image](../uploads/504/54/6645d46c_151a22e0018__8000_00010026.jpg)
Utricle Cysts
usually midline
![card image](../uploads/505/55/6645d46c_151a22e0018__8000_00010030.gif)
Retention cyst
usually lateral
![card image](../uploads/506/56/6645d46c_151a22e0018__8000_00010034.jpg)
Ejaculatory duct cyst
Usually lateral & central
![card image](../uploads/923/77/6645d46c_151a22e0018__8000_00011245.jpg)
pain
rectal and prostate tenderness
Fever
Prostatitis
![card image](../uploads/507/57/6645d46c_151a22e0018__8000_00010036.jpg)
Accessory Spleen
![card image](../uploads/508/58/6645d46c_151a22e0018__8000_00010038.jpg)
Splenic granulomas
focal lesions resulting from previous infection
![card image](../uploads/509/59/6645d46c_151a22e0018__8000_00010040.jpg)
Hemangioma
![card image](../uploads/510/60/6645d46c_151a22e0018__8000_00010042.jpg)
Splenic infarct
common in patients with bacterial endocarditis and splenic artery aneurysms
![card image](../uploads/511/61/6645d46c_151a22e0018__8000_00010046.jpg)
general abdominal sepsis
Splenic Abscess
![card image](../uploads/512/62/6645d46c_151a22e0018__8000_00010048.jpg)
Splenic Artery Aneurysm
![card image](../uploads/527/77/6645d46c_151a22e0018__8000_00010050.jpg)
Crus of the diaphragm
![card image](../uploads/528/78/6645d46c_151a22e0018__8000_00010052.jpg)
Crus of the diaphragm
![card image](../uploads/529/79/6645d46c_151a22e0018__8000_00010054.jpg)
Crus of the diaphragm
![card image](../uploads/530/80/6645d46c_151a22e0018__8000_00010058.jpg)
asymptomatic
cushing's
conn's
Adreanal Adenoma
![card image](../uploads/531/81/6645d46c_151a22e0018__8000_00010062.jpg)
cushing's
Adrenal Cortical Carcinoma
![card image](../uploads/532/82/6645d46c_151a22e0018__8000_00010064.jpg)
hypertension
headache
palpitations
tachycardia
anxiety
excessive persperation
Pheochromocytoma
tumor arising from the adrenal medusa
![card image](../uploads/533/83/6645d46c_151a22e0018__8000_00010066.jpg)
most common childhood adrenal mass
Adrenal Neuroblastoma
![card image](../uploads/534/84/6645d46c_151a22e0018__8000_00010068.png)
Myelolipoma
benign, nonfunctioning adrenal masses that contain fat
![card image](../uploads/535/85/6645d46c_151a22e0018__8000_00010070.jpg)
large neonate
difficult birth
Adrenal Hemorrahage
![card image](../uploads/536/86/6645d46c_151a22e0018__8000_00010074.png)
Caucasian male
75 year old
hypertension
abdominal, back and leg pain
palpable abdominal mass
Fusiform aneurysms
![card image](../uploads/537/87/6645d46c_151a22e0018__8000_00010078.jpg)
Sacular aneurysms
rare
![card image](../uploads/538/88/6645d46c_151a22e0018__8000_00010084.jpg)
Pseudoaneurysm
![card image](../uploads/539/89/6645d46c_151a22e0018__8000_00010092.jpg)
tearing back pain
shock
headache
abdominal pain
Aortic Dissection
![card image](../uploads/540/90/6645d46c_151a22e0018__8000_00010086.jpg)
tearing back pain
shock
headache
abdominal pain
Aortic Dissection
![card image](../uploads/541/91/6645d46c_151a22e0018__8000_00010094.jpg)
Gastoesophageal Junction
![card image](../uploads/542/92/6645d46c_151a22e0018__8000_00010096.jpg)
Pain over McBurney's point
umbilical pain shifting to RLQ
loss of appetite
leukocytosis
rebound tenderness
Acute appendicitis
![card image](../uploads/543/93/6645d46c_151a22e0018__8000_00010098.jpg)
3 - 6 months old
projectile vomiting
palpable olive shaped abdominal mass
Hypertrophic Pyoric Stenosis
![card image](../uploads/544/94/6645d46c_151a22e0018__8000_00010100.jpg)
Fever
leukocytosis
LLQ pain
Diverticulitis
![card image](../uploads/545/95/6645d46c_151a22e0018__8000_00010118.jpg)
abdominal distension
pain
vomiting
hypotension
leukocytosis
Small bowel Obstruction
![card image](../uploads/546/96/6645d46c_151a22e0018__8000_00010114.jpg)
Colon obstruction
![card image](../uploads/547/97/6645d46c_151a22e0018__8000_00010126.jpg)
vomiting
abdominal pain
rectal bleeding
Intussception
![card image](../uploads/548/98/6645d46c_151a22e0018__8000_00010130.jpg)
vomiting
abdominal pain
rectal bleeding
Intussception
![card image](../uploads/549/0/6645d46c_151a22e0018__8000_00010132.jpg)
Biloma
![card image](../uploads/924/78/6645d46c_151a22e0018__8000_00011247.jpg)
renal trauma
renal transplant
Urinoma
![card image](../uploads/550/1/6645d46c_151a22e0018__8000_00010134.jpg)
failed thompson test
Achilles Tendon Rupture
![card image](../uploads/551/2/6645d46c_151a22e0018__8000_00010136.jpg)
inability to extend knee
Patellar tendon Rupture
![card image](../uploads/552/3/6645d46c_151a22e0018__8000_00010138.jpg)
matted bowel loops
malignant ascites
Pseudomyxoma Peritonel
...
Hematoma
![card image](../uploads/553/4/6645d46c_151a22e0018__8000_00010140.jpg)
sandwich sign
Lymphadenopathy
![card image](../uploads/554/5/6645d46c_151a22e0018__8000_00010142.jpg)
carpet layer
Baker's Cyst
![card image](../uploads/555/6/6645d46c_151a22e0018__8000_00010144.jpg)
2nd most common tumor of the hand and wrist
Giant Cell tumor (ganglion cyst)
![card image](../uploads/556/7/6645d46c_151a22e0018__8000_00010146.jpg)
Rectus Sheath Hematoma