May 2014

Abnormal structure anterior of the right liver lobe

Clinical Info

Patient was admitted to the hospital with pain in the right upper abdomen. There are raised infection parameters. The referring physician wanted us to confirm a cholecystitis. However because she had had an operation for her choledochal cyst we presumed the gallbladder was also removed.
Note: This is the same patient as Case of the Month - August 2005

Ultrasound Images & Clips

Abnormal structure anterior of the right liver lobe

Abnormal tubular structure anterior of the right liver lobe
Abnormal tubular structure anterior of the right liver lobe
In the other direction the structure is rounded
In the other direction the structure is rounded
Another image of the tubular structure anterior of the liver.
Does this look like a cholecystitis?
Another image of the tubular structure anterior of the liver. Does this look like a cholecystitis?
A larger image of the tubular structure
A larger image of the tubular structure
The structure is rounded. What would be your diagnosis if the structure was in the right lower abdomen
The structure is rounded. What would be your diagnosis if the structure was in the right lower abdomen
There is an appendiculith in the structure
There is an appendiculith in the structure
There is some increased vascularity of the wall
There is some increased vascularity of the wall
video
video
The patient indeed had undergone a cholecystectomy. She did not have a cholecystitis but an appendicitis that was positioned in the upper abdomen anterior of the liver. The patient was operated and the diagnosis was confirmed.
This is another case of an appendicitis anterior inferior of the liver in a young patient who had delivered a baby just a few days prior to the ultrasound examination. The appendix is perforated with a small effusion at the tip
This is another case of an appendicitis anterior inferior of the liver in a young patient who had delivered a baby just a few days prior to the ultrasound examination. The appendix is perforated with a small effusion at the tip
transverse image of the inflamed appendix
transverse image of the inflamed appendix
A few days later she sill has pain and a control examination shows a small effusion at the lower part of the liver. Do you think this is the problem?
A few days later she sill has pain and a control examination shows a small effusion at the lower part of the liver. Do you think this is the problem?
There is a dilatated right kidney do you think this is the result of the previous pregnancy?
There is a dilatated right kidney do you think this is the result of the previous pregnancy?
The left kidney is not dilatated
The left kidney is not dilatated
The right ureter is dilatated and ends in a small ureteric stone
The right ureter is dilatated and ends in a small ureteric stone
X ray of the ureteric stone
X ray of the ureteric stone

Conclusion

Always remember an appendix is commonly but not always positioned in the right lower abdomen. An ectopic lying inflamed appendix can cause clinical confusing symptoms.
Also remember that in incidental cases there can be more than one problem.


Details

  • Sex: Female
  • Age: 29

Created with

  • Hitachi Ultrasound System