Lower Abdomen
Κάτω Κοιλία
646 images · 5 sub-chapters
Abdominal CT scan. Red outline — fibrous tumor of the liver (Courtesy Dr. V. Penopoulos)
Polycystic liver disease.Red arrow - Contaminated liver cyst.(Courtesy Dr.V.Penopoulos).
Bilateral polycystic kidney disease.Pyonephrosis left side.(Courtesy Dr.V.Penopoulos).
Excision of contaminated hepatic cyst.Visible piece of Surgicel used for hemostasis.(Courtesy Dr.V.Penopoulos).
Yellow arrow - Gallbladder.Blue arrow - Gastric segment.Brown arrow - Transverse colon segment.(Courtesy Dr.V.Penopoulos).
CT Angiography. Presence of a ruptured pseudoaneurysm of the common hepatic artery (Courtesy Dr. V. Penopoulos)
Multiple hepatic abscesses in a patient with cholecystocolic fistulas (Courtesy Dr. V. Penopoulos)
Abdominal CT Scan.Presence of air into the gallbladder.(Courtesy Dr.V.Penopulos).
Colonoscopy.Presence of a gallstone in the transverse colon of another patient.(Courtesy Dr. V. Penopoulos)
Green arrow-T-LGB.Blue arrow-Round ligament.Orange arrow-Falciform ligament.(Courtesy Dr.V.Penopoulos).
Red arrows — Anterior and posterior cystic arteries. Green arrow — Cystic duct (Courtesy Dr. V. Penopoulos)
Red arrow — Inflammatory reaction between the hepatic flexure and gallbladder. Green arrow — Gallbladder. Yellow arrow — Right colon (Courtesy Dr. V. Penopoulos)
Peritoneovenous shunt in another patient with decompensated hepatic cirrhosis (Courtesy Dr. V. Penopoulos)
Multiple hepatic abscesses in other patients with cholecystocolic fistulas (Courtesy Dr. V. Penopoulos)
Hepatic abscess in a patient with cholecystocolic fistula and gallbladder empyema (Courtesy Dr. V. Penopoulos)
Green arrow-LSG.Blue arrow-Round ligament.Light yellow-Right hepatic lobe.Dark yellow-Left hepatic lobe.(Courtesy Dr.V.Penopoulos).
Green arrow-T-LGB.Blue arrow-Round ligament. (Courtesy Dr. V. Penopoulos)
Plain Chest X-Ray.Cystic lesion with air-fluid level in the right lung.(Courtesy Dr.V.Penopoulos).
Abdominal computed tomography. Cystic lesion of the right lung. Courtesy Dr. V. Penopoulos.
Firm adhesion of the hepatic flexure-Yellow arrow-to the gallbladder-Green arrow.(Courtesy Dr.V.Penopoulos).
Abdominal CT Scan-6th postoperative day.Red arrow-injured duct of Luschka.(Courtesy Dr.V.Penopoulos).
Abdominal CT Scan-6th postoperative day.Red arrow-injured duct of Luschka.(Courtesy Dr.V.Penopoulos).
Red arrow-injured duct of Luschka.(Courtesy Dr.V.Penopoulos).(Courtesy Dr. V. Penopoulos)
Gallbladder carcinoma with infiltrated regional lymph nodes and thickened wall.( Courtesy Dr. V . Penopoulos ).
Total Hysterectomy specimen .Both ovaries occupied by the signet cell gallbladder carcinoma (Courtesy Dr. V. Penopoulos)
Total Hysterectomy specimen .Both ovaries occupied by the signet cell gallbladder carcinoma (Courtesy Dr. V. Penopoulos)
After completion of the pancreatic head resection, the following are demonstrated: (brown arrow) the AAA sac, (blue arrow) the confluence of the superior mesenteric vein with the splenic vein and the formation of the portal vein, and (green arrow) the body of the pancreas (Courtesy Dr. V. Penopoulos)
The preoperative placement of a plastic stent in the common bile duct is visible (Courtesy Dr. V. Penopoulos)
Blue arrow – The body of the pancreas, fully mobilized, ready for the pancreaticogastric anastomosis, and Green arrow – Jejunal loop, ready for the gastrojejunal anastomosis (Courtesy Dr. V. Penopoulos)
Completion of the pancreaticogastric anastomosis – Green arrow – demonstrates the pancreas secured within the gastric lumen (Courtesy Dr. V. Penopoulos)
The continuation of the AAA sac below the level of the ligament of Treitz (Courtesy Dr. V. Penopoulos)
Surgical specimen ( pancreatic head ) following modified Whipple’s operation.(Courtesy Dr . V . Penopoulos).
Urine microscopy showing the presence of bile cast .(Courtesy Dr . V. Penopoulos).
Preparation of vascular branches and excision of mesopancreas.(Courtesy Dr . V . Penopoulos).
Total pancreatectomy + D2 lymphadenectomy specimen.(Courtesy Dr . V . Penopoulos).
MRCP image confirms the absence of gallbladder and a normal biliary tree (Courtesy Dr. V. Penopoulos)
Pre-operative ultrasound with equivocal visualization of the gallbladder.( Courtesy Dr . V . Penopoulos ) .
Intraoperative image showing the absence of gallbladder and hepatic pedicle: (Courtesy Dr. V. Penopoulos)
Intra-operative photograph demonstrating non-visualization of the gallbladder upon liver elevation.( Courtesy Dr . V . Penopoulos ) .
Compression of the common hepatic duct by the right hepatic artery is evident. Red arrows: right and left hepatic artery. Blue arrow: proper hepatic artery. Brown arrow: common hepatic artery. Purple arrow: gastroduodenal artery (Courtesy Dr. V. Penopoulos).
Tumor situated in the confluence of the right and left hepatic ducts.( Courtesy Dr . V. Penopoulos ) .
Figure 2 . Macroscopic view of the tumor – cut surface . ( Courtesy Dr . V. Penopoulos ) .
ERCP image of a possible gallbladder stricture. ( Courtesy Dr . V . Penopoulos ) (Courtesy Dr. V. Penopoulos).
Gastrografin swallow pass . The intragastric site of the drainage tube is evident . The protruding mass in the stomach ( green arrow ) represents the pancreatic remnant pancreato-gastric anastomosis (Courtesy Dr. V. Penopoulos)
Gross image of the gallbladder stricture. ( Courtesy Dr . V . Penopoulos ) (Courtesy Dr. V. Penopoulos).
The radio-opaque "sucked" drain is shown-Red arrows.(Courtesy Dr.V.Penopoulos).
Abdominal CT Scan, showing possible choledochal cyst, accessory gallbladder or gallbladder diverticulum.( Courtesy Dr . V . Penopoulos ).
Abdominal MRI showing probably a type II choledochal cyst. ( Courtesy Dr . V . Penopoulos ) (Courtesy Dr. V. Penopoulos).
Encirclement of superior and inferior right hepatic veins.( Courtesy Dr.V.Penopoulos).
Haemorrhage within the ruptured cyst but without active extravasation.(Courtesy Dr.V.Penopoulos).
Sizeable metastatic focus of the liver, occupying segments V, VI, VII, and part of VIII.(Courtesy Dr. V.Penopoulos).
Sizeable metastatic focus of the liver, occupying segments V, VI, VII, and part of VIII.(Courtesy Dr. V.Penopoulos).
Abdominal CT scan. Hemorrhagic rupture of a simple hepatic cyst without active hemorrhage. The presence of free intraperitoneal fluid is noted (Courtesy Dr. V. Penopoulos)
Appendectomy specimen-The "burned" mesoappendix by the pancreatic juice is evident.(Courtesy Dr.V.Penopoulos).
Necrotic tissues removed from head and body of pancreas.(Courtesy Dr.V.Penopoulos).
Resected specimen.Tumour infiltrating the duodenum, pancreas, and lower bile duct.(Courtesy Dr.V.Penopoulos).
Abdominal U/S-Hypoechoic structure between the right kidney and the liver.(Courtesy Dr.V.Penopoulos).
En bloc excision of the pancreatic carcinoma together with the stomach and spleen.( Courtesy Dr . V . Penopoulos ).
Blue arrow - blind orifice of the cystic duct.(Courtesy Dr. V. Penopoulos).
Hepatomegaly.Compensated micronodular alcoholic liver cirrhosis.(Courtesy Dr . V . Penopoulos).
Sagittal opening of the specimen . Red arrows - gastric mucosa.Green arrows - Central pancreatic tumor necrosis.( Courtesy Dr . V . Penopoulos ) .
En bloc excision of the pancreatic carcinoma together with the stomach and spleen.( Courtesy Dr . V . Penopoulos ).
The area of gastric invasion by the expanding pancreatic carcinoma being the cause if intermittent bleeding is clearly demonstrated . Courtesy (Dr . V . Penopoulos).
Cross - section of pancreatic carcinoma.The central necrosis is pointed by forceps. ( Courtesy Dr . V . Penopoulos ).
Abdominal CT Scan .Huge pancreatic tumor ,invading spleen ,proximal stomach and left kidney.(Courtesy Dr. V. Penopoulos)
CT Scan. Cystic dilatation of intrahepatic biliary duct with mucinous content (Courtesy Dr. V. Penopoulos)
Abdominal ECHO . Cystic dilatation of intrahepatic biliary duct (Courtesy Dr. V. Penopoulos)
Cholangiography . Cystic dilatation of intrahepatic biliary duct.(Courtesy Dr.V.Penopoulos).
Left hepatectomy specimen.Dilated biliary duct lined by columnar epithelium (Courtesy Dr. V. Penopoulos)
Abdominal U/S.Cystic dilatation of biliary duct in the left hepatic lobe.(Courtesy Dr.V.Penopoulos).
INTERNAL FEMALE GENITALIA
(177 images)
Liver
(81 images)
Biliary System
(46 images)
Pancreas
(91 images)
Spleen
(96 images)
Splenic graft within the omental pouch, secured to the parietal peritoneum in the left subdiaphragmatic area (Courtesy Dr. V. Penopoulos)
Upper abdominal CT scan 1 year after splenic autotransplantation. Enhancement of the transplanted splenic tissue after contrast injection is evident, demonstrating its viability and function (Courtesy Dr. V. Penopoulos)
Splenic artery aneurysm at the organ's hilum, rendering splenectomy the only option.
Epithelial splenic cyst. The trabeculated internal surface is visible, which may exhibit various types of epithelial lining (Courtesy Dr. V. Penopoulos)
Distal pancreatectomy-splenectomy specimen, with the ruptured splenic artery aneurysm visible (Courtesy Dr. V. Penopoulos)
Epithelial splenic cyst. The trabeculated internal surface is visible, which may exhibit various types of epithelial lining (Courtesy Dr. V. Penopoulos)
Surgical specimen of simple splenic cyst, removed by partial splenectomy.(Courtesy Dr. V. Penopoulos)
Epithelial splenic cyst. The trabeculated internal surface is visible, which may exhibit various types of epithelial lining (Courtesy Dr. V. Penopoulos)
CT Scan. Solitary, thin walled splenic cyst without the presence of calcifications.(Courtesy Dr. V. Penopoulos)
CT Scan. Solitary, thin walled splenic cyst without the presence of calcifications.(Courtesy Dr. V. Penopoulos)
Abdominal CT Scan.Multiple pathological changes in the spleen.(Courtesy Dr.V.Penopoulos).
Macroscopic image of the splenectomy specimen. Littoral cell angioma (Courtesy Dr. V. Penopoulos)
a) Splenic white pulp, enlarged with the presence of a large number of neoplastic cells (small and round). b) Villous lymphocytes, characteristic of SMZL (Courtesy Dr. V. Penopoulos)
Non Hodgkin's splenic lymphoma.(Courtesy Dr.V.Penopoulos)(Courtesy Dr. V. Penopoulos)
Splenectomy for the management of Primary Myelofibrosis.(Courtesy Dr. V. Penopoulos)
Figure 2 . The cut surface of the spleen , showing multiple sponge-like vascular spaces . ( Courtesy Dr . V . Penopoulos ) .
Abdominal CT Scan.Space occupying lesions of the spleen.(Courtesy Dr.V.Penopoulos).
Green arrow – Splenic pedicle. Red arrow – Spleen fixed in retroperitoneal position. (Courtesy Dr . V .Penopoulos).
Red arrow-Wandering spleen.Pink arrow- Gastric volvulus. Brown arrow - Liver.(Courtesy Dr. V. Penopoulos).
TIPS - Transjugular intrahepatic portosystemic shunt installation.(Courtesy Dr.T.Maris) .
TIPS - Transjugular intrahepatic portosystemic shunt installation.(Courtesy Dr.T.Maris) .
Diagram of hepatic venous pressure gradient measurement. (Courtesy Dr. V. Penopoulos)
The enlarged spleen in cross-section – dark-coloured, soft and elastic consistency. (Courtesy Dr. V. Penopoulos.
Presence of abundant large, atypical cells.Primary Angiosarcoma. (Courtesy Dr. V. Penopoulos).
Abdominal CT Scan.Notable splenic enlargement with heterogeneous composition and presence of multiple low density lesions.(Courtesy Dr.V.Penopoulos).
Schematic presentation of collateral venous circulation and develoement of fundal varices.
Abdominal CT Scan.Visible presence of varices at the hilum of the spleen.(Courtesy Dr.V.Penopoulos). (Courtesy Dr. V. Penopoulos)
