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Technique

Sagittal View (Longitudinal)

  • With the indicator oriented toward the patient’s head, the transducer is placed just above the symphysis pubis and is directed into the pelvis (Fig. 24.17).

  • Identify the bladder (triangular in this view when fully distended), uterus (pear-shaped if present), prostate, seminal vesicles, and rectum (Figs. 24.18 and 24.19).

FIGURE 24.17

Suprapubic Sagittal View. The transducer indicator is oriented toward the patient’s head and the transducer is placed just above to the symphysis pubis and is directed into the pelvis. (Photo contributor: Lawrence B. Stack, MD.)

FIGURE 24.18

Normal Male Pelvis, Sagittal View. The bladder appears triangular in this view. The prostate and seminal vesicles can be seen to the right of the screen, just deep to the bladder. (Illustration contributor: Robinson M. Ferre, MD; ultrasound contributor: Jeremy S. Boyd, MD.)

FIGURE 24.19

Normal Female Pelvis, Sagittal View. The uterus appears pear-shaped in this view, and may be anteroflexed or retroflexed. The “pouch of Douglas” is a potential space between the uterus and the rectum, and is deep to the uterus. (Illustration contributor: Robinson M. Ferre, MD; ultrasound contributor: Jeremy S. Boyd, MD.)

Technique: Transverse View

  • With the indicator oriented toward the patient’s right, the transducer is placed about 1 to 2 cm above the symphysis pubis and the beam is angled through the bladder into the peritoneum (Fig. 24.20).

  • Identify the bladder (rectangular in this view when fully distended), uterus (oval hyperechoic structure if present), prostate, seminal vesicles, and rectum (Fig. 24.21).

FIGURE 24.20

Suprapubic View, Transverse. The indicator is oriented to the patient’s right and the beam angled through the bladder into the peritoneum. (Photo contributor: Lawrence B. Stack, MD.)

FIGURE 24.21

Suprapubic View, Transverse. The bladder appears rectangular in this view. The uterus/cervix or prostate/seminal vesicles can be seen deep to the bladder. (Ultrasound contributor: Jeremy S. Boyd, MD.)

Abnormal Findings

  • Hemoperitoneum (male pelvis): Free fluid in the male pelvis is seen as anechoic (black) areas filling the rectovesicular space, the potential space between the bladder and the rectum. The rectovesicular space is immediately cephalad to the extraperitoneal prostate and seminal vesicles. In the sagittal view, it is easier to see this junction that distinguishes the peritoneal cavity from the ...

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