Liver transplantations are increasingly being performed, thus requiring accurate evaluation of related complications. Ultrasonography is the first screening technique for the detection of complications of liver transplantation. The authors report the finding of fluid collection around the falciform ligament in the immediate postoperative period of liver transplantation in patients with no signs of intraabdominal sepsis. This finding was observed in 33 (94.3%) of the 35 patients evaluated. The authors consider this finding to be a normal occurrence in the immediate postoperative period of liver transplantation.

Keywords: Liver, Liver transplantation, Ultrasonography

Ultrasound represents an important contribution to the diagnosis of hepatosplenic mansonic schistosomiasis. Abnormalities such as hyperechoic fibrotic bands along the portal vessels, volumetric reduction of the right hepatic lobe, enlargement of the left lobe, perivesicular fibrotic thickening and splenomegaly can be recognized. Moreover, the hemodynamic status of the portal venous system may also be evaluated by Doppler analysis, including the identification of collateral veins and portosystemic venous shunts. In endemic areas, ultrasound is of great value in the identification of hepatosplenomegaly, allowing follow-up of patients under clinical treatment. This review presents the ultrasonographic and Doppler features of hepatosplenic schistosomiasis. The relationship between these findings and the clinical and pathological characteristics of this disease are also discussed.

Keywords: Schistosomiasis, Liver, Ultrasound

The authors report a case of a 24 year-old female patient with a three-month history of pain and enlargement of the left halux. Ultrasound showed a heterogeneous, hypoechoic solid soft tissue mass with cystic areas and calcification in the dorsum of the left halux. A tendinous structure was identified within the lesion but no evidence of involvement of adjacent osseous structures was found. Doppler ultrasound revealed central and peripheral hypervascularization of the lesion. Magnetic resonance imaging demonstrated a solid soft tissue mass containing a tendinous structure. The lesion appeared as an intermediate signal intensity structure on T1 images, high signal intensity on T2 images, and showed marked enhancement after intravenous administration of gadolinium. No osseous lesions were identified. The patient was submitted to surgical resection of the lesion in the dorsum of the left halux and the pathology results revealed a monophasic fibrous synovial sarcoma.

Keywords: Synovial sarcomas, Soft-tissue tumors, Ultra-sonography, Magnetic resonance imaging

The authors review the use of intraoperative ultrasonography (IOUS) in the management of biliary-pancreatic disease. The methodology of IOUS used for the examination of the biliary-pancreatic ductal system as well as the most important findings and pitfalls of image interpretation are described. Additionally, some ultrasonography findings in pancreatic tumors, pancreatitis, bile duct tumors and bile duct stones are presented. The authors emphasize the importance of understanding this ultrasonographic method due to the increasingly use of IOUS in biliary-pancreatic surgery.

Keywords: Intraoperative ultrasonography, Pancreas, Biliary ductal system

Ewing's sarcoma and Triton's tumor are two uncommon bone tumors of the skull that have nonspecific clinical and imaging features. However, imaging methods are important in the detection of the lesions during the diagnostic investigation in order to evaluate the extent of the bone lesions, involvement of soft tissues and brain, and to determine the presence of local recurrence and metastases. The confirmatory diagnosis relies on histological studies and immunohistochemistry. The authors report two cases of patients with these tumors and present the radiological findings.

Keywords: Ewing's sarcoma, Triton's tumor, Bone tumors, Skull, Computed tomography

The authors describe the main applications of endoscopic ultrasonography for the management of diseases of the gallbladder and biliary ductal system. In addition, some ultrasound findings of benign and malignant diseases affecting these structures of the digestive tract are presented, emphasizing the diagnostic importance of endoscopic ultrasonography.

Keywords: Ultrasonography, Endoscopic ultrasonography, Digestive tract, Gallbladder, Biliary system

We analyzed the ultrasonographic findings of 21 patients with mild acute pancreatitis. The presence or absence of pancreatic hypoechogenicity and peripancreatic fluid collection was assessed. Pancreatic hypoechogenicity was identified in 19 patients (90.5%) whereas small sac fluid collection was identified in 3 (15.8%) of these patients. No abnormality was seen in 2 patients (9.5%). Regarding the etiology of acute pancreatitis, cholelithiasis was identified in 15 patients (71.5%), alcohol abuse was identified in 4 patients (19.0%), and in 2 patients (9.5%) no probable etiology could be found. The authors conclude that ultrasonography may identify abnormalities in the majority of patients with mild acute pancreatitis and can be used to assess patients with peripancreatic fluid collections.

Keywords: Acute pancreatitis, Complications, Ultrasonography

The authors review the main applications of endoscopic ultrasonography in the management of diseases of the pancreas. Ultrasound findings of malignant and benign diseases affecting these segment of the digestive tract and the importance of endoscopic ultrasonography for their diagnosis are discussed.

Keywords: Ultrasonography, Endoscopic ultrasonography, Digestive tract, Pancreas

The authors review the main applications of endoscopic ultrasonography in the management of diseases of the esophagus, stomach, colon and rectum. The methodology and the main findings at endoscopic ultrasonography are discussed as well as ultrasound findings of malignant and benign diseases of the esophagus, stomach, colon and rectum.

Keywords: Ultrasonography, Endoscopic ultrasonography, Digestive tract

Intraspinal synovial cysts of the lumbar spine are rare and commonly associated with osteoarthritis of the facet joints, particularly at level L4-L5. Symptoms are uncommon and may include low-back pain or sciatica. These cysts are accurately diagnosed by using computed tomography and magnetic resonance imaging. Diagnosis is essential for the correct management of the cysts. Several treatment options are available including rest and immobilization, computed tomography guided corticosteroids injection, and surgery in patients that are nonresponsive to other treatment methods.

Keywords: Synovial cysts, Computed tomography, Facet joints

The authors present a case of a patient with primary pancreatic leiomyosarcoma and describe the ultrasound findings during intraoperative ultrasonography. Although ultrasound, computed tomography and magnetic resonance features of primary pancreatic leiomyosarcomas have been previously described, there is no report on the ultrasonographic appearance of these tumors during intraoperative ultrasonography. The authors also stress the importance of intraoperative ultrasonography in establishing vascular invasion by the tumor.

Keywords: Intraoperative ultrasonography, Pancreas, Pancreatic tumors, Pancreatic leiomyosarcoma

The authors report a case of a patient with multiple hepatic adenomas diagnosed by intraoperative ultrasonography (IOUS). Thirteen lesions were observed by IOUS. Preoperative abdominal sonography, helical computed tomography and magnetic resonance imaging revealed only three lesions, which were initially considered to be resectable. All hepatic adenomas had the same texture of the hepatic parenchyma and were not detected by palpation. IOUS is considered to have greater accuracy in identifying hepatic nodules than preoperative imaging methods. In the present study, the authors considered that IOUS was essential for the diagnosis of multiple adenomas, and allowed changing the surgical approach. Because of the multiple lesions identified by IOUS, the patient was not eligible for surgical resection as it would be impossible to remove all the nodules. Up to the knowledge of the authors, it has not been previously described the diagnosis of multiple hepatic adenomas exclusively by IOUS.

Keywords: Intraoperative ultrasonography, Liver, Liver tumors, Multiple hepatic adenomatosis