CH 4-6 - Abdomen Study Guide

What is the upper limit of normal for a measurement of the common bile duct in an 80-year-old female who has had a cholecystectomy?

10mm

What disorder is characterized by neonatal jaundice, cirrhosis, portal hypertension, and the triangular cord sign?

Biliary atresia

Which of the following should the sonographer carefully examine in the urinary bladder of a patient who has undergone a pancreatic transplant?

Formation of an urinoma secondary to a bladder anastomosis

How does the function of the spleen differ in infants/children and adults?

In infants/children, its primary function is defense against infection, whereas in adults, it is production of lymphocytes and monocytes

Which of the following best describes the flow of bile?

Liver - RT or LT hepatic ducts - common hepatic duct (CHD) - cystic duct - gallbladder - common bile duct (CBD) - ampulla of Vater - sphincter of Oddi - duodenum

A 3-year-old patient presents with nausea, LUQ pain, and abdominal distension. On sonographic exam, multicystic masses with hypoechoic locules and hyperechoic septations are demonstrated. What is the most likely diagnosis?

Lymphangioma

Which of the following best describes malignant disease of the spleen?

Lymphoma is the most common malignancy of the spleen presenting as multiple hypoechoic masses throughout the spleen

What is the proper measurement for measuring the common bile duct?

Measure the segment on the extrahepatic side of the cystic duct with an inner-to-inner measurement

A patient presents with jaundice, right upper quadrant pain, an elevated serum bilirubin and a fever. Sonogram demonstrates a common hepatic duct measuring 12 mm. What is the most likely diagnosis?

Mirizzi syndrome

What congenital anomaly of the pancreas causes a functional obstruction leading to pancreatitis?

Pancreatic divisum

Which portion of the pancreas lies in the C-loop of the duodenum?

Pancreatic head

A complex cystic mass is demonstrated in the spleen with posterior dirty shadow in a febrile patient. What is the most likely diagnosis?

Splenic abscess

What acute disorder is best described sonographically as a hypoechoic wedge-shaped mass within the spleen?

Splenic infarct

What is the most common complication of a wandering spleen?

Splenic torsion

What is the term used to describe an enlarged spleen?

Splenomegaly

What posterior landmark can the sonographer use to aid in delineation of the pancreas?

Superior Mesenteric Vein and splenic vein

Which of the following is most accurate when describing Klatskin tumors?

Tumors are generally located at the junction of the RT and LT hepatic ducts

What pathology is diagnosed by the sonographic demonstration of worms in the bile ducts?

Ascariasis

A motor vehicle patient from the emergency room presents with LUQ pain and decreased hematocrit. What should the sonographer look for on the abdominal scan?

A complex or hypoechoic mass in the spleen with posterior enhancement and an echogenic line within the spleen demonstrating the laceration

Which of the following best describes a simple splenic cyst?

Asymptomatic, round, smooth-walled mass with posterior enhancement

Which of the following is not a sonographic finding for acute pancreatitis?

Atrophic hypoechoic pancreas

A 50-year-old patient presents with an acute episode of choledocholithiasis and thickening of the bile duct walls. If the patient is presented with Charcot triad clinically, what is the most likely diagnosis?

Acute bacterial cholangitis

A patient presents with weight loss, jaundice, and epigastric pain. The sonogram demonstrates a hypoechoic mass in the pancreatic head and a dilated CBD. What is the most likely diagnosis?

Adenocarcinoma

What is the most common primary pancreatic malignancy?

Adenocarcinoma

What is the most common cause of acute pancreatitis?

Alcohol abuse

What is the origin of the splenic artery?

Branch of the celiac axis

Which disorder of the gallbladder is associated with cystic kidney disease?

Caroli Disease

Which sonographic sign is associated with Caroli disease?

Central dot sign

What are the complications associated with choledochal cyst?

Cholangitis, portal hypertension, pancreatitis, and liver failure

A 1-year-old patient presented with a palpable abdominal mass, jaundice, and fever. A cystic mass is noted in the area of the porta hepatis with sonography. What is the most likely diagnosis?

Choledochal cyst

What is the least common cause of bile duct obstruction?

Cholelithiasis

A patient presents with a history of chronic alcohol abuse and hyperparathyroidism. The sonogram demonstrates a small pancreas with a complex cystic mass demonstrated along the border of the pancreatic tail. What is the most likely diagnosis?

Chronic pancreatitis

What organs should be closely interrogated if the common bile duct is dilated?

Complete biliary tree, liver, gallbladder, and pancreas

What is the most common complication associated with annular pancreas?

Duodenal obstruction

What is the most significant lab result indicating acute pancreatitis?

Elevated lipase

What is the most common acute vascular complication associated with pancreatic transplants?

Elevated resistive index

What is the cause of a pancreatic pseudocyst?

Encapsulation of digestive enzymes that leak out of the pancreas to form a cystic structure

Which of the following is false in respect to the pancreas?

Exocrine function of the pancreas is performed by the islets of Langerhans

What is the recommended preparation for a bile duct scan?

Fasting for a minimum of 4 hours

What is Charcot triad?

Fever, right upper quadrant pain, and jaundice

What is a common cause of pneumobilia?

Fever, right upper quadrant pain, and jaundice

Which type of islet cell tumor causes patients to develop peptic ulcers?

Gastrinoma

Arterial blood supply to the pancreas is supplied by which of the following arteries?

Gastroduodenal artery, splenic artery, and superior mesenteric artery

Which splenic pathology is often associated with Beckwith-Wiedemann syndrome?

Hamartoma

What is the most common mass found in the spleen?

Hemangioma

What other disorder should be investigated for if pancreatic cysts are noted on a sonogram?

Hippel-Lindau disease

What does the term cholangitis refer to?

Inflammation of the bile ducts

Which of the following best describes the location of the spleen?

Intraperitoneally located in the left upper quadrant (LUQ)

Which of the following best describes a mucinous cystadenocarcinoma?

Multilocular cystic mass with mural nodules and internal echoes with dilation of the duct of Wirsung

Which of the following best describes a splenic granuloma?

Multiple small echogenic masses with acoustic shadowing

Which of the following falsely describes an accessory spleen?

Polysplenia

What is the most common cause of splenomegaly?

Portal hypertension

What is the function of the white pulp in the spleen?

Production of lymphocytes

What is the function of the bile ducts?

Provide a conduit for bile to get from the liver to the digestive system

Which of the following is a vascular complication associated with acute pancreatitis?

Pseudoaneurysm of the splenic artery

What patient position typically allows for best visualization of the spleen?

Right lateral decubitis with deep inspiration

If the patient history includes inflammatory bowel disease, fibrotic thickening of the bile ducts, and cholangiocarcinoma, what is the most likely diagnosis?

Sclerosing cholangitis

Which of the following best describes a chronic condition that results in fibrotic replacement and atrophy of the spleen?

Sickle cell anemia

What is the classic sonographic appearance of a pancreas demonstrating chronic pancreatitis?

Small, hyperechoic, heterogeneous, atrophic gland with ill-defined borders

How is splenomegaly diagnosed from ultrasound?

Spleen extends beyond inferior pole of left kidney and measures >13 cm length or >6 cm thickness