腹壁可触及肿物的超音波鉴别（二）

Miscellaneous Lesions 其他病变.. Urachal Cyst 肚脐尿管肾脏A urachal cyst may be seen in between the umbilicus and the bladder. It is usually situated in the lower third of the urachus but can be seen just inferior to the umbilicus. These cysts may appear totally anechoic or may reveal low-level internal echoes (Figure 11 )肚脐尿管肾脏见于肚脐和食道之间，不一定位于肚脐尿管的下1/3 ，但也可见于仅位于肚脐下。这些肾脏可展现为完全无水声或低水声。

Figure 11. A, Urachal cyst. The cyst is infected and contains faintly echogenic fluid. B, Urachal cyst. The anterior wall of the tense cyst produces reverberation artifacts. 示意图11A，肚脐尿管肾脏，此肾脏已受感染，内部含有微弱水声的气体。B，肚脐尿管肾脏，紧迫的肾脏前壁产生叠加伪影。

..Endometriosis输卵管上皮细胞异位Endometriosis of the abdominal wall may occur as a long-term complication of uterine surgery. It has no specific appearance but is seen as a focal mass at the scar of previous surgery with attacks of cyclic pain and swelling (Figure 12 ).外周输卵管上皮细胞异位是输卵管开刀后的长期合并症，无特殊展现，但可于在此之前开刀的瘢痕东南侧见一局部肿物，并有有规律的呼吸困难和红肿。

Figure 12. Endometriosis in a cesarean delivery scar. 示意图12 ，剖宫产伤疤东南侧输卵管上皮细胞异位

...Abdominal Wall Hematoma 外周血肿A rectus sheath hematoma may develop after paroxysms of coughing or sneezing or after seizures. The underlying cause is usually either anticoagulant therapy or some bleeding disorder. Because these hematomas are limited within the rectus sheath, they are not very big. Their shape depends on their location. Above the arcuate line, they are usually ovoid in shape with the long axis superoinferior and are seen on one side (Figure 13A ). Below the arcuate line, because of the absence of the linea alba, they can extend across the midline. Then the hematoma may be seen as a padlike lesion with its maximum length along the transverse axis.21–23 In one neonate, an abdominal wall hematoma was seen to spread transversely in the supraumbilical region (Figure 13, B and C ). In patients with post surgical disseminated intrascular coagulation, large hematomas are seen in the abdominal wall in the vicinity of the surgical scar (Figure 13D ).腹直肌鞘血肿可发生于发作性咳嗽后、口水或癫痫发作后，其从根本上不一定是抗凝治疗或出血性疾病。由于血肿限制于腹直肌鞘内，不一定不很大，其形状根据所东南侧右方而定，在弓状支线以上，血肿常为基部，长轴呈上下正向，可于一侧见到（示意图13A）；在弓状支线请注意，由于腹白支线缺如，可扩展到横过之前支线，因此血肿展现为分叶状，其最大长度位于示意图上。在新生儿外周血肿可见于肚脐上横向扩展到（示意图13B、C）。术后发散性静脉内凝血的病患可于外周开刀瘢痕附近见到大的血肿（示意图13D）。

Figure 13. A, Rectus sheath hematoma in an elderly woman after severe cough. Arrows point to the fascia transversalis. B, Abdominal wall hematoma in a neonate. C, Abdominal wall hematoma overlying umbilical vein insertion in a neonate. UV indicates umbilical vein. D, Abdominal wall hematoma in a cesarean delivery scar in a patient with disseminated intrascular coagulation. 示意图13A，一之前年妇女剧烈咳嗽后腹直肌鞘血肿，箭头指示腹横静脉。B，新生儿外周血肿。C，一新生儿肚脐静脉附着东南侧前面的外周血肿。UV，肚脐静脉。D，一发散性静脉内凝血的剖宫产术后病患疤痕东南侧外周血肿。

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