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Image of the Fortnight Telescopic Submandibular Approach to
Abdominal
Peritonsillar Abscess About Us

Faculty and Staff

Cardiac The IOW this week comes from Dr. Liz Davlantes who cared for a patient with a peritonsillar
Image of the Week
abscess. It is not uncommon to suspect a peritonsillar abscess based on physical exam and
IVC then face challenges actually finding the fluid pocket when you go to perform the drainage. Calendar
These patients often wait for CT imaging to confirm the diagnosis. As an alternative
Research
Lung ultrasound can be used at the bedside to identify a peritonsillar abscess and facilitate
drainage. Traditionally the endocavitary probe is placed in the mouth in direct contact with Contact Us
Misc the posterior oropharynx. This technique gives great images as seen here. Emory EM Home

Ocular Unfortunately, it can be uncomfortable for the patient. In addition, it is difficult to fit both Related Links
the ultrasound probe and your needle in the mouth at the same time to guide drainage in
OBGYN real time. As an alternative Dr. Davlantes used a “telescopic submandibular approach” to
identify a PTA. To do this the curvilinear or linear probe is placed under the chin with the
Procedures indicator marker pointed towards the neck to obtain what is essentially an upside down,
sagittal cut though the floor of the mouth as a window to the tonsils. On the image below a
Soft Tissue, Vascular, and MSK small anechoic abscess is identified in the center of the image.

Hip Swelling in the Image

Immunocompromised Patient

Crush injury to the posterior

thigh...

Direct Blow to the Thigh

Massive DVT

Playing tennis and you feel a

pop?

Achilles Tendon Rupture

A Swollen Leg ...

Organic Foreign Body

Soft Tissue Foreign Body

Foreign Body Localization

Hip Effusion

Achilles Tendon Rupture

Sewing Needle in the Foot

Right Knee Pain

In this case the technique was used to locate the abscess but it can be taken a step further
Felon Waterbath and used in real time to guide your drainage. For an amazing educational video that reviews
Telescopic Submandibular this technique check out this video from Brooke Hensley and Andrew Liteplo at MGH.
Approach to Peritonsillar
Abscess https://sites.google.com/site/mghedus/home/ultrasound-
tutorials/tutorialtelescopicsubmandibularapproachtodiagnosinganddrainingperitonsillarabscesses
Shoulder Pain following
Seizure
Thanks for all of your great images this week!
A Swollen Leg ...
Happy Scanning!
Fracture Healing...

Upper Extremity DVT ===============================

Pain and a Pop Sierra Beck MD

Should we drain that?
Assistant Professor
A Swollen Fingertip
Department of Emergency Medicine
Persistent cellulitis despite
antibiotics
Emory University SOM
A diabetic with foot pain

Trauma

Image of the Fortnight

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