History & PEEUS Scan

Problem 1
?
1. 2. 3. 4. 6 8 10 12

Longitudinal ultrasound view of the normal right kidney

Transverse ultrasound view of the normal right kidney

Normal left kidney

Normal filled urinary bladder

Male Pelvis

Problem 2
6530 Severity 9/10 ?
1. 2. 3. 4.
9

Acute flank pain/ suspected renal colic

EUS: obstruction AAA
10

Overview of degrees of hydronephrosis

11

Renal stone
EUS:
Hyperdense lesion with acoustic shadow

12

Problem 3
? 1. Renal stone 2. Hydronephrosis 3. Hydroureter 4. Ureteral stone 5. UVJ stone

71F, left flank pain Left ureteral stone with obstruction

14

Left UVJ stone

15

Left UPJ stone with obstruction

16

59M, left flank pain & hematuria AAA and ruptured AAA

17

56F, severe left back pain Obstructive uropathy with urine extravasation

18

Bladder
?
Acute urine retension

U/Cfailure ?
Bladder size evaluation

19

 (ml) = * * * 0.75 (error: 15-35%)

Bladderindexvolume(AP*Transverse)2.4cm2 =2ml
20

63M, right flank pain & hematuria Bladder tumor with right hydronephrosis

21

21F with painful voiding Ketamine-related interstitial cystitis

22

Problem 4
70 BUN/Cr 25/0.7 89/5.6 ?
1. 2. 3. 4. Pre-renal cause Intrinsic cause Post-renal cause

Acute renal failure

: post-renal obstruction

24

AUR with bilateral hydronephrosis

25

Renal cyst
1. 2. 3. 4. EUS smooth, round, or oval no internal echo well-defined margin posterior enhancement
26

61F, fever & left flank pain Simple cyst v.s. infected cyst

27

61F, fever & left flank pain Simple cyst v.s. infected cyst

28

Problem 5
49 ?
1. 2. 3. 4. Emphysematous pyelonephritis Acute pyelonephritis Renal abscess Obstructive uropathy

29

Complicated UTI (APN & renal abscess)

EUS 1. Risk factors 2. Treatment failure 3. Severe sepsis/septic shock
30

Right emphysematous pyelonephritis

50F, septic shock

31

48F with fever for 4 days Left renal abscess

68F, fever with pyuria/ bedridden Right pyonephrosis

33

Pyonephrosis

34

49F, fever & left flank pain * 2wks Emphysematous pyelonephritis

35

49F, fever & left flank pain * 2wks Emphysematous pyelonephritis

36

Emphysematous pyelonephritis

37

Emphysematous pyelonephritis

38

68F, fever & chills Emphysematous cystitis

39

68F, fever & chills Emphysematous cystitis

40

Fever with right flank/back pain Obstructive uropathy with psoas muscel abscess

41

Difficult voiding and defecation for two weeks Rectovesicle fistula

42

Problem 6
25 ? 1. Sonography 2. Contrast-enhanced CT 3. IVP 4. MRI

Trauma
EUS Highly operator dependent gross hematuria, or CECT
44

57M, severe left flank pain s/p ESWL Subcapsular hematoma

45

57M, severe left flank pain s/p ESWL Subcapsular hematoma

46

95M, abdominal pain with bloody ascites Bladder rupture

47

Others
What about kidneys ??

48

Painful left flank Renal infarction

Right flank pain Renal tumor

Painful right flank with family history of urolithiasis Ruptured angiomyolipoma

Left flank pain TCC related hydronephrosis


Juice119.pixnet.net Juice119@gmail.com
53