Negacion
Paciente masculino de 45 años de edad, con aspecto de enfermo crónico, con abdomen distendido y signos evidentes de "arañas vasculares " en ambas mejillas, que suelen estar relacionadas con cirrosis hepática de origen alcohólico. A la pregunta de la causa de la visita al medico referidor ( un generalista ), refiere que es a instancias de sus familiares que le notan la barriga " hinchada ". Niega ingesta importante de alcohol, hepatitis o cualquier otra enfermedad. Se confiesa fumador importante. Dice que anualmente se hace un chequeo de rutina y que en el examen anterior ( en otro centro ) le dijeron que solo tenia un quiste en riñón derecho.
Al comienzo del examen sonografico de abdomen con transductor sectorial de 3.5 Mhz, encontramos una vena esplenica aumentada de calibre, lo cual ya nos decía que el Bazo iba a estar aumentado de tamaño ( Esplenomegalia ). El hígado ,aunque lucia con aspecto sonografico dentro de cierta normalidad, tenia una medida de 18,9 cms ( normal hasta 15 cms ). El riñón derecho mostraba un pequeño quiste simple de unos 8.2 c.c. de volumen, pero, ademas se aprecia la presencia de múltiples focos hipo-ecogenicos de diferentes formas y tamaños, altamente sugestivos de pielonefritis aguda, por ultimo el Bazo muestra un volumen muy aumentado ( 1034 c.c. ).
Como se ve, el paciente esta muy bien ( lo dice él, come con muy buen apetito y todo le cae muy bien ), razones que hicieron que arqueara las cejas con gesto de incredulidad.
Male patient, 45 years old, chronically ill-looking, with distended abdomen and signs of "spider veins" on both cheeks, which are often associated with cirrhosis of alcoholic origin. When asked the reason for the visit to the doctor referrals (a generalist), states that it is urged by his family to notice his belly bloated. Denies alcohol intake, hepatitis, or another disease. He admits important smoking. He says that each year becomes a routine checkup and that in the previous examination (in another center) said he had only a cyst in the right kidney.
At the beginning of the abdominal sonographic examination with a 3.5 MHz sector transducer, we found an increased caliber of splenic vein, which has already told us that the spleen was to be enlarged (splenomegaly). The liver, although sonographic looking into some normalcy, I had a measure of 18.9 cm (normal up to 15 cms). The right kidney showed a small cyst of about 8.2 cc volume but also shows the presence of multiple hypo-echogenic foci of different shapes and sizes, highly suggestive of acute pyelonephritis, finally, the spleen shows a greatly increased volume (1034 cc).
As shown, the patient is very good (he says he eats with a good appetite and everything like him), reasons that caused his eyebrows to arch in disbelief.
Al comienzo del examen sonografico de abdomen con transductor sectorial de 3.5 Mhz, encontramos una vena esplenica aumentada de calibre, lo cual ya nos decía que el Bazo iba a estar aumentado de tamaño ( Esplenomegalia ). El hígado ,aunque lucia con aspecto sonografico dentro de cierta normalidad, tenia una medida de 18,9 cms ( normal hasta 15 cms ). El riñón derecho mostraba un pequeño quiste simple de unos 8.2 c.c. de volumen, pero, ademas se aprecia la presencia de múltiples focos hipo-ecogenicos de diferentes formas y tamaños, altamente sugestivos de pielonefritis aguda, por ultimo el Bazo muestra un volumen muy aumentado ( 1034 c.c. ).
Como se ve, el paciente esta muy bien ( lo dice él, come con muy buen apetito y todo le cae muy bien ), razones que hicieron que arqueara las cejas con gesto de incredulidad.
Denial
Male patient, 45 years old, chronically ill-looking, with distended abdomen and signs of "spider veins" on both cheeks, which are often associated with cirrhosis of alcoholic origin. When asked the reason for the visit to the doctor referrals (a generalist), states that it is urged by his family to notice his belly bloated. Denies alcohol intake, hepatitis, or another disease. He admits important smoking. He says that each year becomes a routine checkup and that in the previous examination (in another center) said he had only a cyst in the right kidney.
At the beginning of the abdominal sonographic examination with a 3.5 MHz sector transducer, we found an increased caliber of splenic vein, which has already told us that the spleen was to be enlarged (splenomegaly). The liver, although sonographic looking into some normalcy, I had a measure of 18.9 cm (normal up to 15 cms). The right kidney showed a small cyst of about 8.2 cc volume but also shows the presence of multiple hypo-echogenic foci of different shapes and sizes, highly suggestive of acute pyelonephritis, finally, the spleen shows a greatly increased volume (1034 cc).
As shown, the patient is very good (he says he eats with a good appetite and everything like him), reasons that caused his eyebrows to arch in disbelief.
Esplenomegalia
Hepatomegalia
Aumento Calibre V. Esplenica
Pielonefritis Riñón Derecho
Quiste Simple Riñón Derecho
