Interactive Transcript
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Pseudomyxoma on CT does have a different
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appearance than it does on the brain.
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Regular ascites on CT, but it also has
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a different appearance on ultrasound.
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So this is the same patient who came in for a
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paracentesis, knowing that it was a ruptured
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mucosal and that it was going to contain more
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dense kind of material here that a paracentesis
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might not work, but they were out of options and
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the patient was extraordinarily uncomfortable
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given how much fluid they had in their belly.
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So here's a picture from
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an ultrasound right here.
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You can see your bowel loops kind of
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floating in this material right here.
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And again, you can just see this
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isn't anechoic, simple free fluid.
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It is insinuating in between these bowel
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loops, but it has more echogenicity to it,
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all these echogenic kind of foci in it.
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So you go through here, this
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is absolutely legitimate.
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This isn't just artifact.
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This is really, you know, some hyperdense
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material within the cystic space.
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Right here.
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And because of that, you would warn the
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patient that when you do this paracentesis,
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you may not get a lot of fluid out.
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This may be too thick to come out your
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paracentesis catheter, but that given
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discomfort, it may be worthwhile.
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The other things that you can look for
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on these is this will actually move
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when you put an ultrasound probe, but
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if you push their belly a little bit.
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So here's an image from the paracentesis
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itself, you can see the needle coming in, but
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importantly too, you can see this material
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kind of move around as well.
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This isn't artifact, this is actually
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the mucin and that thick, thick kind
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of fluid that's in there as well.
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So you can try paracentesis with these.
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This one actually was fairly successful, got
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a couple liters out and helped the patient,
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but they may not always be successful
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and you have to counsel the patient that.
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