US of Blunt Abdominal Trauma: Importance of Free Pelvic Fluid in Women of Reproductive Age1
Claude B. Sirlin, MD,
Giovanna Casola, MD,
Michèle A. Brown, MD,
Nirav Patel, MD,
Eli J. Bendavid, MD,
Reena Deutsch, PhD and
David B. Hoyt, MD
1 From the Departments of Radiology (C.B.S., G.C., M.A.B., E.J.B.), Surgery (N.P., D.B.H.), and Family and Preventive Medicine (R.D.), UCSD Medical Center, 200 W Arbor Dr, San Diego, CA 92103-8756. From the 1998 RSNA scientific assembly. Received April 14, 2000; revision requested June 6; revision received June 30; accepted August 8. R.D. supported in part by National Institutes of Health grant M01 RR00827. Address correspondence to C.B.S. (e-mail: csirlin@ucsd.edu).
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Figure 1a. (a) Transverse transabdominal US image in a 30-year-old woman reveals a small pocket of anechoic fluid (straight arrow) in the rectouterine recess extending into the right ovarian fossa (curved arrow), as confirmed with (b) transverse contrast material-enhanced CT scan.
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Figure 1b. (a) Transverse transabdominal US image in a 30-year-old woman reveals a small pocket of anechoic fluid (straight arrow) in the rectouterine recess extending into the right ovarian fossa (curved arrow), as confirmed with (b) transverse contrast material-enhanced CT scan.
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Figure 2a. (a) Longitudinal transabdominal US image in a 37-year-old woman depicts a small fluid collection with questionable echoes and dependent debris, which possibly represents pelvic hemoperitoneum, in the CDS (arrow). b = bladder, u = uterus. (b) Sagittal transvaginal scan shows that the fluid (arrow) is anechoic, which suggests a physiologic cause. bo = bowel, u = uterus.
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Figure 2b. (a) Longitudinal transabdominal US image in a 37-year-old woman depicts a small fluid collection with questionable echoes and dependent debris, which possibly represents pelvic hemoperitoneum, in the CDS (arrow). b = bladder, u = uterus. (b) Sagittal transvaginal scan shows that the fluid (arrow) is anechoic, which suggests a physiologic cause. bo = bowel, u = uterus.
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Figure 3a. (a) Longitudinal transabdominal US image of the pelvis in a 20-year-old woman shows a small collection (arrow) in the CDS. b = bladder, u = uterus. (b) Transverse contrast-enhanced CT scan reveals a focal fluid collection in the right iliac fossa (arrow), which was not depicted at screening US. Low-attenuating fluid identical to the collection seen at US was confirmed on a more inferior image (not shown). A 1-cm bladder dome laceration was found at cystography and confirmed at laparotomy.
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Figure 3b. (a) Longitudinal transabdominal US image of the pelvis in a 20-year-old woman shows a small collection (arrow) in the CDS. b = bladder, u = uterus. (b) Transverse contrast-enhanced CT scan reveals a focal fluid collection in the right iliac fossa (arrow), which was not depicted at screening US. Low-attenuating fluid identical to the collection seen at US was confirmed on a more inferior image (not shown). A 1-cm bladder dome laceration was found at cystography and confirmed at laparotomy.
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Figure 4a. (a) Longitudinal transabdominal US image of the pelvis in a 24-year-old woman depicts a small amount of anechoic fluid (curved arrow) in the CDS adjacent to hyperechoic bowel (bo). In addition, some fluid extends superiorly over the uterine fundus and bladder dome and into the SVS (straight arrows). (b) Transverse contrast-enhanced CT image of the upper abdomen reveals extensive liver laceration (arrows).
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Figure 4b. (a) Longitudinal transabdominal US image of the pelvis in a 24-year-old woman depicts a small amount of anechoic fluid (curved arrow) in the CDS adjacent to hyperechoic bowel (bo). In addition, some fluid extends superiorly over the uterine fundus and bladder dome and into the SVS (straight arrows). (b) Transverse contrast-enhanced CT image of the upper abdomen reveals extensive liver laceration (arrows).
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Copyright © 2001 by the Radiological Society of North America.
