Dr Sarimul Hoque Mazumder

07/10/2023

07/10/2023

07/10/2023

Mole
A 21 year old woman, primigravida, with history of 3 months amenorrhoea presents with vaginal bleeding.

Report:
Image A: Transabdominal view of the uterus. The uterus appears bulky and is filled with a mass of mixed echogenicity. Multiple tiny anechoic cystic spaces are seen in the uterine cavity. Both ovaries were normal in size.

Image B: Transabdominal image of the uterus. The classical bunch-of-grapes appearance or snow-storm appearance in the uterine cavity is noted. Conclusion.

Complete hydatidiform mole.

Dr Sarimul Hoque Mazumder
MBBS MS Obst & Gyne
Guwahati Obstetric & Gynaecological Society Indian Council of Medical Research Gynecology and Obstetric

07/10/2023

Endometrial hyperplasia is an abnormal thickening of the endometrial lining of the uterus; endometriosis is the growth of endometrial cells outside of the uterus.

Finding:
Normal sized uterus measuring 38mm in AP diameter.
The myometral echoes are uniform . The endometrial plate is thickened (14mm) with uniform echotexture,but no focal endometrial lesion or collection demonstrated.. Both adnexae and the POD are within normal limits.


Endometrial hyperplasia ? Hormonal imbalance r/o early cyesis. PT will clarify.

Dr Sarimul Hoque Mazumder
MBBS MS Obst & Gyne
Guwahati Obstetric & Gynaecological Society Indian Council of Medical Research Gynecology and Obstetric

07/10/2023

A bulky uterus is a condition that is also called adenomyosis. This occurs when the endometrial lining grows into the muscle of the uterus The finding of the glandular material in the uterinewall may cause the uterus to become enlarged called hypertrophy.

Finding:
The uterus is bulky but empty measuring about 61mm in AP diameter.
The myometral echoes are uniform. The endometrial plate is within normal limits. NO RPOC is seen.
Both adnexae/parametral regions and the POD are within normal limits.


Bulky uterus can cause uninvolution.

Dr Sarimul Hoque Mazumder
MBBS MS Obst & Gyne
Guwahati Obstetric & Gynaecological Society
Indian Council of Medical Research
Indian Association Of Cosmetic Gynecology
Gynecology and Obstetrics

07/10/2023

*Definition:
Micro gallbladder is defined as less than 2-3 cm long and 0.5 -1.5 cm wide. Micro gallbladder can be seen most commonly in cystic fibrosis but is also seen in idiopathic neonatal hepatitis and alpha-1-antitrypsin deficiency.
In cystic fibrosis, which is a hereditary condition, there is abnormal production of thick viscid mucus by the affected glands. According to two studies by Jebbink, et al and by Strandvik, et al; liver and gallbladder abnormalities are quite common in patients with cystic fibrosis. Noteworthy amongst these complications are-
1. Fatty infiltration of the liver
2. Liver fibrosis
3. Cirrhosis
4. Cholelithiasis
5. Micro- gallbladder and
6. Sclerosing cholangitis.
The exact pathogenetic mechanism of biliary complications in cystic fibrosis is not well understood. Cystic fibrosis occurs due to mutations in the gene for the cystic fibrosis transmembrane conductance regulator channel [the CFTR gene]. In the liver, the CFTR is located in the biliary epithelial cells and appears to be responsible for normal bile formation. Therefore, a defective CFTR channel in cystic fibrosis is responsible for the liver and biliary abnormalities. Jebbink, et al suggested the following meachanism for gallbladder disease:
1. abnormalities in bile acid metabolism, resulting in bile that is supersaturated with cholesterol
2. bile duct stasis due to bile duct abnormalities and/ or impaired gallbladder motility
3. impaired nucleation time
Ultrasound is diagnostic and shows a small contracted gallbladder in cases of micro gallbladder. A micro-gallbladder may provide a clue to the diagnosis of cystic fibrosis.

*Case Study:
A 22 year old man with history of cystic fibrosis presents with right upper quadrant pain. An abdominal ultrasound was performed

*Ultrasound Report:
1st Image: Transverse oblique image of right upper quadrant
Description: This image reveals a small gallbladder, called micro- gallbladder. Thick inspissated material is also seen in the duodenum.
2nd Image: Transverse oblique image of right upper quadrant
Description: This is a labeled image of the micro gallbladder and the duodenum showing the thick inspissated material.

*Conclusion:
Micro gallbladder due to cystic fibrosis.



Dr Sarimul Hoque Mazumder
MBBS MS Obst & Gyne
Indian Council of Medical Research
Guwahati Obstetric & Gynaecological Society Dr Manish Gupta DM, Gastro, Liver & Endoscopy Center

07/10/2023

*Definition:
Gastric polyps are found in 2% to 3% of gastric examinations, usually as incidental findings. The polyps may be neoplastic or non-neoplastic, with most (80% to 90%) being non-neoplastic. They may be multiple or solitary, and some complicate polyposis syndromes.
The two main types of non-neoplastic polyps include hyperplastic polyps and fundic gland polyps. Less commonly, neoplastic (adenomatous) polyps develop. Clinical and endoscopic features are rarely able to distinguish the various types of polyps prior to histologic examination.Most hyperplastic polyps arise on a background of chronic gastritis.
The ultrasound examination in this case was done after making sure the patient had had an adequate amount of water to fill the stomach. A hypoechoic polypoidal lesion was seen arising from the wall with a thin hyperechoic mucosal rim over it. The lesion measured about 8mm in its widest axis. A provisional diagnosis of polyp was made. The endoscopic findings correlated with the ultrasound - a smoothly marginated polyp was seen in the antrum.

*Case Study:
Patient presented with history of recurrent abdomen pain. No obvious history of association with feeding habits was ascertained.

*Ultrasound Report:
This is a transverse scan in the region of the epigastrum showing a water filled stomach outlining a well defined hypoechoic lesion along the stomach wall. The transverse scan in the region of the epigastrum showing a water filled stomach outlining a well defined hypoechoic lesion along the stomach wall.The mucosal surface is hyperechoic

*Conclusion:
Hyperplastic Gastric Polyp



Dr Sarimul Hoque Mazumder
MBBS MS OBST & GYNE
Indian Council of Medical Research

05/10/2023