Karen M. Having

Congenital Splenic Cyst: A Rare Prenatal Finding

A congenital splenic cyst is a rare prenatal sonographic finding. This case reports a 17.6 × 15.1-mm cystic structure visualized in the upper pole of the fetal spleen during a sonographic examination of a primigravida woman in her late 20s who presented at an estimated gestational age (EGA) of 36 weeks, 6 days. This finding was not documented in an earlier scan performed at an EGA of 19 weeks. Etiology, pathogenesis, follow-up, treatment, and differential diagnoses associated with congenital splenic cyst are presented.

Trauma-Induced Testicular Rupture

Traumatic testicular injuries are relatively uncommon. History, physical examination, clinical findings, and scrotal sonography with Doppler studies are important in diagnosing these injuries. The case presented is a classic example of testicular rupture with necrosis resulting from testicular trauma. In the presence of necrosis, orchiectomy is indicated. Findings consistent with testicular rupture, necrosis, and orchiectomy are discussed.

Lab Accreditation and Credentials in Sonography A Demographic Assessment of Facilities Receiving Federal Reimbursements

There is an increasing demand for sonographer credentials and facility accreditation associated with federal reimbursement of sonography examinations. Therefore, a national survey was conducted to identify the education/certification status of sonographers currently performing studies that receive federal reimbursement. The survey, addressed to sonography administrators, also investigated the sonography laboratory accreditation status. Results indicated that approximately 12% of the sonographers were reported to have no sonography-specific credentials. The primary age range of this group was 25 to 34 years, and 64% were graduates of a two-year (minimum) allied health education program other than sonography. Forty-two percent indicated their sonography lab was not accredited. Should the Centers for Medicare and Medicaid Services (CMS) require facility accreditation, there may be a significant impact on sonographer requirements as a condition of employment.

The Fetal Gallbladder A Study of Sonographic Visualization Rate and Dimensions in the Second and Third Trimesters

In a study of 113 routine transabdominal fetal OB exams with estimated gestational age ranging from 14 to 38 weeks, the fetal gallbladder was identified in 93.8% of the examinations. Fetal gallbladder size, shape, and pathologies associated with nonvisualization are discussed.

An Absent Right Umbilical Artery Versus Absent Lt and the Prognostic Implications for the Fetus

A single umbilical artery (SUA) is one of the most common malformations in a fetus, with approximately a 1% occurrence rate. A retrospective study of 108 fetuses with a SUA was done to determine if the laterality of the SUA made a difference in fetal prognosis. An absent right umbilical artery was found in 42 (38.9%) of cases and an absent left umbilical artery in 66 (61.1%) cases. When correlated with fetal outcome, there was a closer association between an absent right umbilical artery with genitourinary anomalies, cardiac defects, and chromosomal abnormalities. There was a nine times greater likelihood (95% confidence interval of a 3 to 27 times greater probability) of a fetal anomaly with an absent right umbilical artery than with an absent left umbilical artery.

Biliary Pseudolithiasis A Reversible Condition

Cholelithiasis is a pathology that can be confidently diagnosed by sonographic examination. The following case presents sonographic findings consistent with cholelithiasis in a child being treated with the antibiotic Rocephin. A follow-up preoperative sonographic examination of the gallbladder displayed no evidence of cholelithiasis. This is a classic example of Rocephin-induced “biliary pseudolithiasis.”