Abstracts S33

submucosal layer, periappendiceal fluid collection, disruption of the se-

rosal layer, asymmetrical wall thickening, maximum overall diameter

.10.5 mm, and the presence of appendicoliths was 85.4, 73.2, 68.3,

70.7, 80.5, and 36.6%, respectively, while the specificity was 65.5,

89.1, 96.4, 98.2, 81.8, and 80.0%, respectively.

Importance of the Conclusions: High-resolution US was found to be

useful for differentiating acute perforated appendicitis from non-perfo-

rated appendicitis.

PD.06.003

Sonographic Findings in Patients With Acute Scrotal Pain

Y. Y. Jung

Eulji Hospital, Eulji University School of Medicine, Seoul,

Repulic of Korea

Introduction: Ultrasonography (US) is the primary imaging modality

for the diagnosis of scrotal diseases. The acute scrotum is a common

in emergency departments. Therefore, US evaluation of the acute

scrotum is common in clinical practice.

Methods Involved: I provides a sonographic findings of conditions

causing acute scrotal pain and a brief review of diseases.

Discussion: In some conditions, such as testicular torsionor rupturemust

be surgically corrected immediately. Therefore, understanding the sono-

graphic findings of conditions causing acute scrotal pain is important.

Conclusion of the Presentation: Understanding the sonographic

features of diseases causing acute scrotal pain helps to accurate diag-

nosis and proper treatment.

PD.06.004

Lymphoma of Abdominal Wall in Emergency: Sonographic

Characterization and Differentials

A. Rahal, Jr. R. Gobbo, C. N. Baldoni, G. Mariotti, P. R. Silv�erio,

M. J. Franscisco Neto

Hospital Israelita Albert Einstein

Brief Description of the Purpose of the Report: The aim is to describe

a case of abdominal wall linfoma in patient with colecistites hipotesis.

Medical History: Female, 89 years with abdominal pain.

Diagnosis: Linfoma.

Discussion and Summary of the Case: It’s most important not limitate

only take the protocol of ultrasound exam.

PD.06.005

Spontaneous Hematoma of the Rectus Abdominis

Muscle - Ultrasound Diagnosis

P. M. V. Franca, B. F. C. Ces�ario, A. C. Barros, G. M. T. Soares,

R. A. P. Silva, R. Figueiredo, J. P. K. Matushita

Hospital Das Cl�ınicas Da Universidade Federal De Minas Gerais, Belo

Horizonte, MG, Brasil

Brief Description of the Purpose of the Report: Spontaneous hema-

toma of the rectus abdominis muscle is the accumulation of blood inside

the abdominal rectus sheath as a consequence of rupture of the epigastric

vessels. It could be mistaken for other abdominal diseases, because of its

clinical presentation.

Medical History: Female, 61 years old, presented at the emergency

department with acute coronary syndrome, submitted to angioplasty

followed by antiplaquetary drugs. She improved clinically, except for

persistent cough. After 20 days, she complained of abdominal pain,

associated with hypotension and tachycardia. Ultrasound showed a large

heterogeneous fluid collection localized inside the belly of the left

abdominal rectus muscle.

Diagnosis: Spontaneous hematoma of the rectus abdominis muscle.

Discussion and Summary of the Case: The spontaneous hematoma of

the abdominal rectus muscle is considered a rare pathology, more

common among women and associated with the use of anticoagulation

drugs, vomits, cough and physical activity. The clinical presentation is

acute abdominal pain with tachycardia, hypotension, echymosis of the

abdominal wall and palpable mass. The use of image is important for

the differential diagnosis with other acute abdominal conditions. Ultra-

sound diagnosis is feasible and desirable due to availability and lack of

radiation, with a sensibility around 71%, allowing a quick and accurate

evaluation of size and localization of the hematoma.

PD.06.006

Ultrasonography - Major Pitfalls to be Known in Urgent

Abdominal Exam

L. D. R. Francisco, D. C. Grassi, V. F. L. Ferreira, M. A. Hirose,

F. M. P. Abdo, F. M. Lote, R. Pinho, V. B. Porcionato, M. T. Passos,

M. J. Francisco Neto, P. Boarini, L. R. Boarini

Transduson, Carapicuiba, Sao Paulo, Brasil

Introduction: Ultrasound examination has its importance increasingly

pronounced in the current scenario, particularly in emergency medicine

and should be known to the examiner the main pitfalls.

Methods Involved: Analysis of Abdominal Ultrasound studies per-

formed in our department, focusing on core abdominal pitfalls of

urgency.

Discussion: The main pitfalls of emergency abdominal examination,

detailed didactic way, allowing a critical analysis of the main points

of error and how to avoid them will be discussed.

Conclusion of the Presentation: The ultrasound examination is essen-

tial in emergency medicine and internal medicine in diseases of the

abdomen, thus knowledge of their traps this situation represents a funda-

mental tool for the examiner know to avoid them.

7 - Ultrasound in Gynecology

PA.07.008

Sonographic Appearance of Krukenberg Tumors. Report

of a Case

J. J. Serrano, S. Garcia-Herreros, M. Romero, R. Moncayo

Ecomedica, Quito, Ecuador

Brief Description of the Purpose of the Report: To discuss ultrasound

findings and color Doppler examination in a case of Krukenberg tumor

secondary to gastric carcinoma.

Medical History: A 67 year-old patient, G2002 presented for a post-

abdominal wall reconstruction ultrasound control. In January 2008,

gastric carcinomawas detected for which the patient underwent subtotal

gastrectomy and lymphadenectomy. Histopathology confirmed a stage

IIA gastric adenocarcinoma, for which combined radiation and chemo-

therapy were offered to the patient, but she refused to receive it. Since

then, clinical follow-up every 6 months with computed tomography

(CT) + endoscopy were perfomed In July 2012, a control CT scan

showed a 6cm tumor on the anterior abdominal wall, which was

removed and abdominal wall reconstruction was performed.

Diagnosis: Bilateral, pure solid, encapsulated and hyperechoic smooth

masses, surrounded by an hypoechoic ring with clear tumor margins

were observed on both ovaries. Abundant vascularization was detected,

with a characteristic tree-shaped structure penetrating from the

periphery of the lesion. Velocity measurement showed the low imped-

ance of intratumoral circulation, with a diminished vascular resistance

(IR 5 0.4).

Discussion and Summary of the Case: Krukenberg tumors are the

presence of any metastasis to the ovaries. Gastric cancer has been