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Case of the Month

September 2010

Patient Data: 58 year old male

Clinical Info: Incidental finding during an ultrasound examination of the lower abdomen in a patient with pain in lower abdomen


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Hypoechoic mass in the left lower abdomen


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Longitudinal image of the mass. The mass has a hilum


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The mass shows vascularity from this hilum


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The mass has a stalk arasing from the hlum


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The mass has a very long stalk


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The mass is located within the descending colon


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Transverse image of the mass showing its position within the descending colon. The lesion proved to be a colon polyp with a very long stalk. The lesion could be removed by endoscope and showed no signs of malignancy


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This image shows another incidentally found structure within the bowel. In this case the jejunum of a 71 year old female patient. It shows a curved tubular structure The structure was interpreted as a possible foreign body like a feeding tube or perhaps a large roundworm


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Another image of the same tubular structure in the same patient within the bowel


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Transverse image of the structue within the small bowel surrounded by some fluid. The diagnosis in this case could not be confirmed because the patient was treated for a completely different problem.

Ultrasound is not a screening method for intraluminal structures, because air within the bowel can obscure lesions. However sometimes intraluminal stuctures like polyps and carcinomas can be found Also sometimes foreign bodies and roundworms can be seen. In the second patient the diagnosis unfortunately could not be confirmed. She never had a tube placed. No foreign body could be retreived and the stucture was not visible on a CT scan made the same day. The patient had not been abroad making a roundworm unlikely.
For any other suggestions please contact the author

For other examples of colon polyps see

References
Tumours of the large bowel and rectum: possibilities and limitations of sonographic evaluation]
Macheiner P, Hollerweger A, Rettenbacher T, Gritzmann N.
Ultraschall Med. 2007 Jun;28(3):301-6.

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