Presentation
Routine pre-operative ultrasound before cholecystectomy
Patient Data
A large complex cystic lesion with mixed echogenicity (fluid and non dependent echogenic content (mostly representing fat)) noted at the left adnexal region, extending to the retro-uterine space. Doppler scan revealed no internal vascularity.
Thick walled gallbladder with pericholecystic edema and large stone inside.
Thin rim of free fluid seen at the Morison pouch.
CT revealed large complex cystic lesion of mixed density (fat, soft tissue and calcifications) seen at the left adnexal region and extending to the retro-uterine space. It is seen compressing the uterus and mildly displacing it to the right side. it is also seen contacting the anterior surface of the rectum with clear fat planes in between.
Case Discussion
The patient underwent routine pre-operative ultrasound examination and revealed signs of acute on top of chronic calculous cholecystitis.
Left ovarian dermoid cyst was also incidentally discovered and diagnosis confirmed by typical appearance on CT.
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