By J. Bates
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Additional info for Abdominal Ultrasound - How, Why and When
It may also help to clarify any confusing appearances of adjacent bowel loops. BILE DUCTS The common duct can be easily demonstrated in its intrahepatic portion just anterior and slightly to the right of the portal vein. 31 Double gallbladder—an incidental finding in a young woman. 32 A contracted, thick-walled gallbladder located in the gallbladder fossa on TS. 34 CBD at the porta hepatis. The lower end is frequently obscured by shadowing from the duodenum. The duct should be measured at its widest portion.
PV = portal vein. 13 TS through the right kidney. 14 TS at the epigastrium. CBD = common bile duct. 15 TS at the inferior edge of the left lobe. 16 LS through the right lobe, demonstrating a Reidel’s lobe extending below the right kidney. ) The segments of the liver It is often sufficient to talk about the ‘right’ or ‘left’ lobes of the liver for the purposes of many diagnoses. However, when a focal lesion is identified, especially if it may be malignant, it is useful to locate it precisely in terms of the surgical seg- ments.
Qxd 6/30/04 26 5:37 PM Page 26 ABDOMINAL ULTRASOUND CD HA A HA PV CD The direction of flow is normally hepatopetal, that is towards the liver. The main, right and left portal branches can best be imaged by using a right oblique approach through the ribs, so that the course of the vessel is roughly towards the transducer, maintaining a low (< 60˚) angle with the beam for the best Doppler signal. 5 The diameter increases with deep inspiration and also in response to food and to posture changes. An increased diameter may also be associated with portal hypertension in chronic liver disease (see Chapter 4).
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