AB-Abdomen Exam Dumps : Abdomen Sonography Examination

Changing the patient's position allows evaluation of lesion mobility. Blood clots and hematomas are often mobile, while true bladder wall masses remain fixed. This technique helps differentiate between solid masses and non-adherent debris.

According to Rumack’s Diagnostic Ultrasound:

“Changing patient position may distinguish between mobile blood clots and fixed bladder wall masses.”

Scrotal inflammation, such as epididymitis or orchitis, typically presents with increased blood flow (hyperemia) on color Doppler sonography. This finding reflects the inflammatory process and vascular dilation. Abscesses, granulomas, or hydroceles may be present but are not as consistent or specific for inflammation.

According to AIUM Practice Parameters and Rumack’s Diagnostic Ultrasound:

“In acute inflammation, color Doppler ultrasound demonstrates prominent hyperemia of the epididymis or testis.”

The CT and ultrasound images show a lenticular-shaped, hypoechoic fluid collection compressing the renal parenchyma from the periphery. The location—between the renal capsule and the renal parenchyma—strongly suggests a subcapsular hematoma.

Subcapsular hematomas in transplant kidneys are uncommon but important postoperative complications, often resulting from trauma, biopsy, or surgical manipulation. They typically present as a crescent-shaped, low-attenuation collection beneath the renal capsule and may cause mass effect on the underlying renal parenchyma. This can impair renal perfusion and function—a phenomenon known as “Page kidney.”

Ultrasound findings:

Anechoic to hypoechoic, crescent-shaped collection surrounding or compressing the transplant kidney.

Deformation or flattening of the renal contour due to the compressive effect of the hematoma.

CT findings:

Hyperdense collection (if acute) or hypodense (if subacute/chronic) located subcapsularly.

May be seen distorting the renal capsule and compressing renal tissue.

Differentiation from other options:

A. Urinoma: Typically appears as a perinephric fluid collection and may result from urine leak. Not usually subcapsular.

B. Lymphocele: Develops in the post-transplant period due to lymphatic disruption. Appears as a well-defined perinephric fluid collection and tends to be medial to the kidney or between the bladder and the kidney.

C. Renal cell carcinoma: Would appear as a solid mass with variable enhancement and not a simple fluid collection. RCC is rare in transplant kidneys and usually detected much later post-transplant.