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Pseudomyxoma Peritonei with US

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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.

Report

Faculty

Kathryn McGillen, MD

Assistant Professor of Radiology, Medical Director of Ultrasound

Penn State University Milton S Hershey Medical Center

Tags

Ultrasound

Neoplastic

Gastrointestinal (GI)

Body

Appendix

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