ENDOVAGINAL AND TRANSABDOMINAL PELVIC ULTRASOUND, 09/14/10
COMPARISON EXAMS: None.
CLINICAL INDICATION: 29-year-old female with history of elevated beta HCG status post
right salpingectomy in Hawaii three weeks ago with no decidual tissue seen in the
pathologic sample and with steadily slowly rising beta HCG levels up to the approximately
400s recently. Evaluate for ectopic pregnancy.
TECHNIQUE: Multiple transverse and longitudinal images through the pelvis were
obtained transabdominally and endovaginally with additional supplemental color flow
imaging. Permanent images were recorded.
DISCUSSION: Within the cervix, there is a 1.1 x 0.7 x 0.9 cm simple cystic lesion without
significant increased vascularity surrounding it and with no associated decidual response
of the endometrium. This likely represents a simple nabothian cyst. A cervical ectopic is
unlikely but cannot be 100% excluded based on this exam. The remainder of the uterus is
normal in appearance. No myometrial or endometrial abnormalities are seen with the
endometrium measuring 3 mm in thickness. The uterus is retroflexed. No distinct
abnormalities of the corneal regions of the uterus are distinctly identified. Within the left ovary which is distinctly separate from the adjacent uterus, there is a
simple cystic structure measuring 0.7 x 0.6 x 0.7 cm with some increased vascularity
surrounding the lesion but not within it. Although this likely represents normal follicle in
this ovary, the possibility of an ovarian ectopic cannot be definitively excluded based on
this exam. The right ovary is normal in appearance measuring 2.4 x 1.4 x 2.3 cm. No free fluid is
seen in the pelvis.These findings were discussed with Dr. Ambani at the time of exam interpretation by
COMPARISON EXAMS: None.
CLINICAL INDICATION: 29-year-old female with history of elevated beta HCG status post
right salpingectomy in Hawaii three weeks ago with no decidual tissue seen in the
pathologic sample and with steadily slowly rising beta HCG levels up to the approximately
400s recently. Evaluate for ectopic pregnancy.
TECHNIQUE: Multiple transverse and longitudinal images through the pelvis were
obtained transabdominally and endovaginally with additional supplemental color flow
imaging. Permanent images were recorded.
DISCUSSION: Within the cervix, there is a 1.1 x 0.7 x 0.9 cm simple cystic lesion without
significant increased vascularity surrounding it and with no associated decidual response
of the endometrium. This likely represents a simple nabothian cyst. A cervical ectopic is
unlikely but cannot be 100% excluded based on this exam. The remainder of the uterus is
normal in appearance. No myometrial or endometrial abnormalities are seen with the
endometrium measuring 3 mm in thickness. The uterus is retroflexed. No distinct
abnormalities of the corneal regions of the uterus are distinctly identified. Within the left ovary which is distinctly separate from the adjacent uterus, there is a
simple cystic structure measuring 0.7 x 0.6 x 0.7 cm with some increased vascularity
surrounding the lesion but not within it. Although this likely represents normal follicle in
this ovary, the possibility of an ovarian ectopic cannot be definitively excluded based on
this exam. The right ovary is normal in appearance measuring 2.4 x 1.4 x 2.3 cm. No free fluid is
seen in the pelvis.These findings were discussed with Dr. Ambani at the time of exam interpretation by
