An interesting example of complex ascites on POCUS. Multiple septations are

Complex Ascites on POCUS - Dr. Michael I. Prats @PratsEM Large amount of free fluid seen in the abdominal cavity with particulate matter floating in it, possibly hemorrhagic and possibly malignant. #Complex #Ascites #POCUS #clinical #ultrasound #abdominal

►

Complex Ascites on POCUS 62 yo F with rec dx colon CA s/p colectomy, liver cirrhosis w ascites who presents with abd pain + distention. Transferred to tertiary care center for diagnostic and tx paracentesis. +constipation, last LVP 2 L about 2 weeks ago, no fevers/chills/sweats On cipro for sbp ppx, WBC 12.5, lactate 2.3, INR 1.4. POCUS performed to eval for adequate ascites pocket for dx + tx paracentesis. In this image in particular, we can identify significant septations and loculations as well as an area of hyperechoic fluid w bright white gas bubbles. - Pitt Internal Medicine Point of Care Ultrasound @PittIMPOCUS #Complex #Ascites #POCUS #SBP #clinical #ultrasound #abdominal #abscess

►

Complex (NOT simple) ascites on Abdominal POCUS (very subtle intra-ascitic echoes--didn't translate to Twitter well) secondary to SBP. Labeled Schematic: https://twitter.com/EUSmkh/status/869585940200796160 #Ascites #Complex #POCUS #clinical #ultrasound #SBP

►

Complex Ascites in SBP on POCUS Setting up for paracentesis. Glad we grabbed the US! ⬆️ suspicion for SBP - VCU Ultrasound @ultrasound_vcu #Complex #Ascites #SBP #POCUS #clinical #ultrasound

►

Secondary Bacterial Peritonitis (SBP) on Abdominal POCUS Cirrhosis with fever/abd pain-?SBP. POCUS for win. Secondary bacterial peritonitis. Diverticular abscess with necrotic segment. Note gas bubbles and pneumoperitoneum. Dr. Robert Jones @RJonesSonoEM #Secondary #Bacterial #Peritonitis #SBP #Abdominal #POCUS #clinical #ultrasound #Gas #Bubbles #Pneumoperitoneum #Complex #Ascites

►

Complex Ascites with Air Bubbles in Colonic Perforation on POCUS Hemodynamically unstable with rigid abdomen. Patient has history of cirrhosis and prior ascites noted in chart. Could this just be "run of the mill" ascites that is incidental finding? True CT is more helpful in distinguishing fluid types but is there a clue here? Look at all the echos within the fluid moving toward the anterior abdomen. These are gas bubbles/air. Always look for air in the wrong place. Also had pneumoperitoneum detected in RUQ. Patient had initial presentation of colon CA with colon perforation and obstruction. Tiny microbubbles seen rising anteriorly, with posterior enhancement also seen = bowel perforation. Always good to look for the abdominal “a” lines just below the peritoneum anteriorly. Dr. Robert Jones @RJonesSonoEM #Ascites #Air #Bubbles #pneumoperitoneum #Perforation #POCUS #clinical #ultrasound #complex

►

Cirrhosis, ascites, edematous gallbladder wall and a gallstone on Abdominal Ultrasound - POCUS Dr. J. Christian Fox @jchristianfox #Cirrhosis #Liver #Gallbladder #Gallstone #Ascites #Ultrasound #POCUS #Clinical #Abdominal

►

Gallbladder Wall Thickening on POCUS Ascites - a common cause of a thick gallbladder wall Dr. J. Christian Fox @jchristianfox #Gallbladder #Wall #Thickening #Edema #Ascites #Ultrasound #POCUS #Clinical #Abdominal

►

Interesting view using linear probe of both ascites and pleural effusion with diaphragm between - Lung Ultrasound Dr. J. Christian Fox @jchristianfox #Diaphragm #lung #pleural #effusion #clinical #radiology #pocus #ultrasound #ascites

►

Small Bowel Obstruction and Ascites on POCUS This patient drove to the ED complaining of 2 hours of symptoms. Which symptoms do you most expect the patient to have? Resolution: Nausea and Vomiting. This clip shows a dilated loop of small bowel floating in a large amount of FF(not hemoperitoneum from trauma—every cm would represent approx 1L of blood, and she would not have driven to the ED), c/w an SBO in the setting of ascites. Labeled Schematic: https://twitter.com/EUSmkh/status/999003416323084289 #SBO #SmallBowel #Obstruction #Ascites #POCUS #Abdominal #clinical #ultrasound

►