Diaphragmatic slips mimicking peritoneal implants

Case contributed by Mohammad Momeni
Diagnosis almost certain

Presentation

History of cancer and presented with ascites

Patient Data

Age: Adult
Gender: Female

Ultrasound shows prominent diaphragmatic slips (yellow arrows) of different sizes, and also the indentation of the liver surface (green arrows). Notice the presence of ascites (red arrows) which allowed better visualization of the findings.

Case Discussion

Diaphragmatic slips are prominent diaphragm muscles which have seen in some conditions mostly in the elderly and emphysematous lung. In ultrasound examination they are similar to echogenic nodules on transverse view, which could be confused with hepatic masses or peritoneal implants, but when you rotate the transducer their shape change to a linear structure which differentiates slips from other diagnoses.

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