Thursday, August 23, 2012

Fibroid complicating a possible ectopic gestation

This young lady has bleeding P/V with a history of  6 weeks amenorrhoea. Ultrasound images are shown below- the top few images being transabdominal ultrasound images, followed by endocavity sonography.
A large mass is seen above the uterine fundus- is it a pedunculated fibroid?

Note the presence of fluid in the cul de sac: see below:

It gets more intriguing as the fluid is echogenic in the transvaginal ultrasound images below suggesting bloody matter in the cul de sac and left adnexal regions. Is there a left adnexal mass within the thickened left Fallopian tube? The mass above the fundus looks like a typical fibroid, possibly pedunculated. The uterine cavity is empty with no sign of a gestation sac. Is the fluid the result of an ectopic in the left fallopian tube or is it due to ruptured hemorrhagic cyst?

Transvaginal color Doppler images of this patient show limited vascularity around and in the left adnexal mass which measures 2 cms. in size:

For more on sonography of ectopic pregnancy visit:

Wednesday, August 8, 2012

Quiz- early gestation sac with what else

This is a 7 week gestation with a viable embryo seen in the intrauterine gestation sac. But what else do you find? And what is that posterior to the uterus? (These ultrasound images were taken with a Philips HD 15 ultrasound system):