ultrasound templates- Lower abdomen

📝 ABDOMEN TEMPLATES

🧾 WAM – Whole Abdomen (Male)

🧾 UA – Upper Abdomen (Male)

🧾 WAF – Whole Abdomen (Female)

🧾 UA – Upper Abdomen (Female)

🧾 WAP – Whole Abdomen (Pediatric)

🧾 KUB – Focused Study

🧾 KUB – With Uterus

🧾 KUB – With Prostate

🧾 Pelvis – Female

🧾 Lower Abdomen – Male

🧾 FAST – Male

🧾 FAST – Female

🧾 FAST – Pediatrics

🧾 Abdominal Doppler – Aorta & IVC

🧾 Abdominal Doppler – Portal & Hepatic

🧾 Abdominal Doppler – Renal

─── 🧾 Pelvis Female ───

Templates

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NORMAL FINDINGS

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ULTRASOUND FINDINGS IN FEMALE PELVIS

UTERUS

[Normal and physiological]

Secretory phase endometrium
Proliferative phase endometrium
Postmenopausal uterus
Postpartum involutional uterus
Retroverted uterus (normal variant)
Anteverted uterus (normal variant)
Post-hysterectomy residual cervical stump

[Diffuse myometrial diseases]

Diffuse uterine enlargement (nonspecific)
Adenomyosis (diffuse)
Focal adenomyosis (adenomyoma)
Cystic adenomyosis
Endometriosis with myometrial involvement
Myometrial hypertrophy
Fibromyomatous change
Fibrosis post-infection
Chronic nonspecific myometritis
Postpartum myometrial edema
Myometrial calcification
Myometrial fatty change
Radiation-induced myometrial fibrosis
Autoimmune myometritis
Metastatic infiltration of myometrium
Infiltrative trophoblastic disease
Vascular congestion (pelvic venous insufficiency)
Post-surgical diffuse myometrial scarring
Endocrine-related myometrial thickening
Diabetic myometrial changes

[Focal Benign Myometrial Lesion]

Leiomyoma (fibroid) – intramural
Leiomyoma – submucosal
Leiomyoma – subserosal
Pedunculated fibroid
Calcified fibroid
Cystic degenerated fibroid
Red (carneous) degenerated fibroid
Hyaline degeneration in fibroid
Myxoid degeneration in fibroid
Fibroid with cystic changes
Fibroid with necrosis
Lipoleiomyoma
Adenomyoma
Fibroid with parasitic attachment
Post-embolization fibroid necrosis
Post-myomectomy residual fibroid
Cervical fibroid
Broad ligament fibroid
Focal adenomyotic nodule
Endometrial polyp with myometrial extension
Focal hematoma mimicking fibroid
Infarcted fibroid
Intraligamentary fibroid
Fibroid with sarcomatous degeneration
Fibroid with torsion

[Endometrial pathologies]

Endometrial hyperplasia – simple
Endometrial hyperplasia – complex
Endometrial polyp
Endometrial cystic change
Endometrial calcification
Endometrial synechiae (Asherman’s syndrome)
Endometrial atrophy (postmenopausal)
Endometrial stromal edema
Endometrial cystic atrophy
Endometrial hematoma
Endometrial abscess
Endometrial tuberculosis
Endometrial fibrosis (post-D&C)
Postpartum endometritis
Post-abortion retained products
Subinvolution of placental site
Endometrial carcinoma
Endometrial sarcoma
Endometrial metastases
Endometrial hyperemia (inflammation)
Polypoid endometrial thickening
Endometrial necrosis (ischemic)
Endometrial cystic degeneration
Endometrial pseudocyst
Hormonal endometrial change
Tamoxifen-induced endometrial change
Post-IUD endometrial changes
Endometrial fluid collection
Endometrial sloughing (menstrual phase)
Endometrial regeneration (early proliferative phase)
Postmenopausal bleeding cause – benign thickening
Endometrial carcinoma with myometrial invasion
Endometrial stromal nodule
Endometrial polyp with cystic degeneration
Mixed endometrial lesion (polyp + hyperplasia)

[Congenital and developmental anomalies]

Uterine agenesis
Unicornuate uterus
Bicornuate uterus
Didelphys uterus
Septate uterus (complete/incomplete)
Arcuate uterus
Hypoplastic uterus
T-shaped uterus (DES exposure)
Cervical duplication
Uterine horn remnant
Müllerian duct anomaly – unspecified
Rudimentary horn with pregnancy
Uterine duplication with single cervix
Transverse vaginal septum with uterine anomaly
Hemi-uterus
Agenesis of cervix
Accessory uterine cavity
Uterine fusion anomaly
Partial uterine septum
Associated renal agenesis (MURCS association)
Non-fused Müllerian duct anomaly
Uterine diverticulum
Congenital uterine AV malformation
Uterine duplication with double vagina
Uterine malposition with congenital cause

[Infective and inflammatory]

Acute endometritis
Chronic endometritis
Pelvic inflammatory disease (PID)
Salpingitis with tubo-ovarian abscess (with uterine reaction)
Endometrial tuberculosis
Actinomycosis of endometrium
Post-abortal infection / retained products with infection
Postpartum endometritis with myometritis
Septic deep myometritis
Parametritis
Peri-uterine abscess
Fungal endometritis (Candida)
Viral endometritis (CMV/HSV)
Foreign-body granulomatous reaction (IUD related)
Localized uterine abscess
Infective myometrial abscess
Cholangio-uterine inflammatory extension (rare)
Chronic pelvic inflammatory scarring
Actinomyces-associated pelvic inflammation
Reactive endometrial hyperemia
Granulomatous myometritis
Post-instrumentation inflammatory change
Chronic cervicitis with endometrial extension
Bacterial vaginosis–associated uterine reaction
Endometritis with intracavitary fluid/echogenic debris

[Vascular, perfusion and hemorrhagic]

Uterine artery aneurysm
Uterine artery pseudoaneurysm
Congenital uterine arteriovenous malformation (AVM)
Acquired uterine AVM (post-procedural)
Subchorionic hemorrhage
Intramural hematoma
Subserosal hematoma
Retained products with active vascularity
Trophoblastic vascular invasion (invasive mole)
Uterine torsion with vascular compromise
Uterine infarction (postpartum or ischemic)
Placental site vessel malformation
Massive hemorrhage with uterine perfusion changes
Uterine venous plexus dilatation (pelvic congestion)
Segmental uterine hypoperfusion
Hyperemic endometrium (inflammatory/vascular)
Post-procedural uterine arterial bleed
Doppler-dependent trophoblastic flow (persistent)
Coagulopathy-related uterine hematoma
Hemoperitoneum secondary to uterine rupture

[Gestational and pregnancy-related]

Normal intrauterine pregnancy (viable)
Missed/incomplete abortion
Retained products of conception (RPOC)
Ectopic pregnancy (tubal) with uterine reaction
Cesarean scar pregnancy
Molar pregnancy (hydatidiform mole)
Invasive mole / gestational trophoblastic neoplasia (GTN)
Heterotopic pregnancy
Subchorionic hemorrhage in early pregnancy
Placental site nodule / placental polyp
Placenta accreta spectrum (accreta/increta/percreta)
Placental abruption with uterine findings
Uterine rupture in pregnancy
Uterine dehiscence post-cesarean
Postpartum retained placental tissue
Uterine inversion (postpartum)
Uterine subinvolution of placental site
Choriocarcinoma involving myometrium
Intrauterine fetal demise with retained products
Gestational trophoblastic hemorrhagic degeneration
Monochorionic twin complications affecting uterus
Molar pregnancy with theca-lutein ovarian change
Ectopic pregnancy implant in cesarean scar
Pregnancy-related vascular malformations
Uterine arteriovenous fistula after delivery

[Malignant and premalignant]

Endometrial carcinoma (type I – endometrioid)
Endometrial carcinoma (type II – serous/clear cell)
Endometrial intraepithelial neoplasia (EIN)
Endometrial stromal sarcoma
Uterine leiomyosarcoma
Carcinosarcoma (malignant mixed Müllerian tumor)
Adenosarcoma of uterus
Undifferentiated uterine sarcoma
Endometrial hyperplasia with atypia (premalignant)
Cervical carcinoma with uterine extension
Metastatic disease to uterus (breast, melanoma, GI)
Gestational trophoblastic neoplasia (invasive)
Uterine serosal surface malignancy
Primary uterine lymphoma
Peritoneal carcinomatosis with uterine invasion
Neuroendocrine tumor involving endometrium
Mesenchymal tumors with malignant potential
Carcinoma of lower uterine segment
Vulvar/vaginal carcinoma secondarily involving uterus
Leiomyoma with sarcomatous degeneration
Persistent atypical polypoid adenomyoma
Endometrial carcinoma with deep myometrial invasion
Uterine papillary serous carcinoma
Metastatic trophoblastic tumor

[Traumatic, post-surgical and iatrogenic]

Uterine laceration/rupture
Postoperative uterine hematoma
Post-myomectomy fluid collection/hematoma
Post-hysterectomy pelvic collection
Post-dilation and curettage (D&C) cavity changes
Iatrogenic uterine perforation
Post-embolization uterine necrosis/changes
Post-ablation scar (endometrial / myometrial)
Surgical clip/foreign-body artifact
Post-laparoscopic trocar injury to uterus
Retained surgical sponge granuloma
Post-cesarean scar niche / isthmocele
Post-uterine artery embolization (UAE) change
IUD malposition with uterine wall erosion
Post-radiation uterine fibrosis
Post-procedural pseudoaneurysm
Post-biopsy intramural hematoma
Adhesive bands causing uterine distortion
Post-procedural infection/abscess
Scarring with cavity obliteration (Asherman variant)

[Systemic and endocrine-related]

Polycystic ovary syndrome–related uterine change
Endocrine hyperplasia (unopposed estrogen)
Tamoxifen-related endometrial change
Diabetic uterine changes
Thyroid disease associated uterine findings
Cushingoid steroid-related endometrial change
Autoimmune endometritis (SLE, other connective tissue)
Granulomatous disease with uterine involvement
Hematologic disorder–related bleeding/hematoma
Coagulopathy-associated uterine hemorrhage
Systemic amyloidosis with uterine deposition
Liver disease–related bleeding / gynecologic effect
Adrenal hyperplasia effect on endometrium
Hyperprolactinemia-related endometrial change
Ovarian hyperstimulation syndrome effect on uterus
Drug-induced endometrial atrophy or hyperplasia
Metabolic syndrome–related endometrial thickening
Hematologic malignancy affecting uterus
Endocrine paraneoplastic uterine effects
Idiopathic non-gynecologic systemic uterine response

[Extrauterine and secondary (ec) causes]

Pelvic endometriosis involving uterine serosa
Adnexal mass compressing uterus (ovarian cyst/tumor)
Large fibroid uterus compressing adnexa
Peritoneal carcinomatosis with uterine involvement
Pelvic lymphadenopathy causing uterine displacement
Rectovaginal / vesicouterine fistula effects on uterus
Retroperitoneal fibrosis with secondary uterine displacement
Urinary bladder tumor invading anterior uterine wall
Pelvic abscess causing secondary uterine inflammation
Ileal / sigmoid tumor adherent to uterus
Appendicular mass with secondary uterine change
Hydronephrosis causing mass effect on uterus
Pelvic lipomatosis compressing uterine contour
Diaphragmatic hernia with thoracoabdominal shift (rare)
Abdominal aortic aneurysm mass effect on uterus
Large uterine fibroid with secondary ovarian torsion
Pelvic venous congestion from pelvic varices
External compression by pregnancy-related adnexal masses
Secondary uterine involvement from tuberculosis elsewhere
Metastatic nodal disease at porta of pelvis causing compression

OVARY

[Normal and physiological]

Normal ovary follicular phase
Normal ovary luteal phase
Dominant follicle
Corpus luteum normal
Corpus luteum with central clot
Corpus luteum with ring of fire Doppler sign
Corpus luteal cyst
Simple follicular cyst
Multiple follicles physiologic
Prepubertal ovary normal small follicles
Postmenopausal ovary atrophic
Postpartum ovary
Polycystic ovary functional appearance
Periovulatory follicle rupture Mittelschmerz
Luteal cyst with peripheral hyperemia

[Functional and benign cystic lesions ]

Simple ovarian cyst
Functional cyst unspecified
Follicular cyst persistent
Corpus luteal cyst hemorrhagic
Theca lutein cyst
Luteinized unruptured follicle
Hyperreactio luteinalis
Early Hemorrhagic cyst
Endometriotic cyst – endometrioma
Endometrioma with ground-glass echoes
Ruptured endometrioma fluid with debris
Luteal phase cyst persistent
Paraovarian cyst
Paratubal cyst
Cyst of Morgagni fimbrial cyst
Broad ligament cyst
Wolffian duct cyst mesonephric remnant
Multiloculated simple cyst
Cyst with septations benign
Cyst with thin internal echoes proteinaceous
Giant simple cyst
Peritoneal inclusion cyst
Hydrosalpinx mimicking ovarian cyst

[Complex cystic lesions ]

Hemorrhagic cyst late stage
Endometrioma chronic
HOC Fishnet weave or fine reticular pattern
HOC retracting clot stage
HOC lacy reticular pattern
HOC fluid debris level
HOC Rupture
HOC resembling a solid ovarian neoplasm
Dermoid cyst mature cystic teratoma
Dermoid with echogenic nodule Rokitansky protuberance
Dermoid with fat fluid level
Dermoid with calcified tooth like echoes
Dermoid with hair-like echogenic strands
Mature teratoma with solid component
Immature teratoma solid cystic
Cystadenoma serous unilocular
Cystadenoma serous multiloculated
Cystadenoma mucinous unilocular
Cystadenoma mucinous multiloculated
Cystadenofibroma
Borderline serous tumor
Borderline mucinous tumor
Benign Brenner tumor mixed solid cystic
Cystadenoma with papillary projection
Cystadenoma with hemorrhage
Cyst with mural nodule benign variant
Dermoid with rupture chemical peritonitis
Endometriotic cyst with calcification
Corpus luteum cyst with hemorrhage
Ovarian abscess pyocystic ovary

[Solid benign ovarian lesions ]

Fibroma
Thecoma
Fibrothecoma
Brenner tumor solid form
Lipoma ovarian
Lipoleiomyoma
Myoma arising from ovarian ligament
Ovarian stromal hyperthecosis
Luteoma of pregnancy
Massive ovarian edema
Stromal hyperplasia
Ovarian fibromatosis
Sclerosing stromal tumor
Ovarian cellular fibroma
Ovarian hamartoma
Granulosa cell tumor benign
Leydig cell tumor benign
Sertoli Leydig cell tumor low grade
Steroid cell tumor benign
Ovarian leiomyoma
Ovarian adenofibroma
Ovarian cystadenofibroma solid
Ovarian neurofibroma
Paraganglioma rare
Benign teratoid mass

[Malignant ovarian neoplasms ]

Serous cystadenocarcinoma
Mucinous cystadenocarcinoma
Endometrioid carcinoma
Clear cell carcinoma
Transitional cell carcinoma malignant Brenner
Undifferentiated carcinoma
Mixed epithelial carcinoma
Borderline epithelial tumor intermediate potential
Granulosa cell tumor adult type
Juvenile granulosa cell tumor
Theca cell carcinoma
Sertoli Leydig cell carcinoma
Ovarian carcinosarcoma
Dysgerminoma
Yolk sac tumor endodermal sinus tumor
Embryonal carcinoma
Choriocarcinoma non-gestational
Teratocarcinoma malignant teratoma
Mixed germ cell tumor
Gonadoblastoma
Secondary metastatic ovarian carcinoma
Krukenberg tumor gastric metastasis
Breast carcinoma metastasis to ovary
Colon carcinoma metastasis to ovary
Pancreatic metastasis
Uterine carcinoma metastasis
Lymphoma primary ovarian
Lymphoma secondary involvement
Leukemic infiltration
Sarcomatous ovarian tumor
Melanoma metastasis
Recurrent ovarian carcinoma post-surgery
Post-chemotherapy necrotic mass
Radiation-induced ovarian neoplasm
Ovarian carcinoma with peritoneal spread
Borderline tumor with invasive foci
Carcinoma ex dermoid rare
Mixed germ cell stromal tumor
Ovarian papillary carcinoma serous
Mucinous borderline tumor with microinvasion

[Inflammatory and infective ]

Oophoritis acute
Oophoritis chronic
Tubo-ovarian abscess TOA
Pyosalpinx with ovarian involvement
Hydrosalpinx with ovarian adhesion
Periovarian inflammation
Pelvic inflammatory disease PID ovarian phase
Ovarian abscess
Chronic salpingo-oophoritis
Postpartum ovarian infection
Post-abortal ovarian abscess
Post-surgical oophoritis
Tubercular oophoritis
Actinomycotic infection
Parasitic ovarian abscess rare
Fungal infection Candida
Viral oophoritis mumps
Pelvic cellulitis involving ovary
Ovarian necrosis due to infection
Ovarian phlegmon

[Hemorrhagic, vascular and torsion ]

Ovarian torsion partial
Ovarian torsion complete
Ovarian torsion with hemorrhage
Ovarian infarction post-torsion
Ovarian venous thrombosis
Ovarian artery thrombosis
Ruptured ovarian cyst hemoperitoneum
Luteal cyst rupture
Hemorrhagic cyst rupture
Endometrioma rupture
Torsion of dermoid cyst
Torsion of cystadenoma
Torsion of paraovarian cyst
Torsion with gangrene
Post-embolization ischemia
Pelvic congestion syndrome
Ovarian varices
Vascular ovarian tumor
Arteriovenous malformation rare
Ovarian hematoma post-trauma

[Congenital and developmental]

Accessory ovary
Supernumerary ovary
Ectopic ovary pelvic wall
Ovarian remnant syndrome
Ovarian agenesis unilateral
Ovarian hypoplasia
Gonadal dysgenesis Turners
Streak gonad
Mixed gonadal dysgenesis
Ovotestis intersex gonad
Persistent müllerian duct syndrome ovarian mimic
Ovarian herniation into inguinal canal
Polycystic ovarian morphology developmental variant
Ovarian inclusion cyst embryologic remnant
Heterotopic ovarian tissue accessory tissue
Ovarian duplication
Ectopic ovarian tissue in mesentery
Dysgenetic gonad with neoplasm
Embryonic ovarian cyst neonatal
Neonatal hemorrhagic cyst

[Endocrine and functional disorders]

Polycystic ovarian syndrome PCOS classic
PCOS lean type
PCOS obese type
Ovarian hyperthecosis
Stromal hyperplasia
Luteoma of pregnancy
Hyperreactio luteinalis
Ovarian hyperstimulation syndrome OHSS
Theca lutein cysts multiple
Hypothyroid related cystic changes
Hyperthyroid-related stromal edema
Cushings syndrome ovarian cysts
Androgen secreting tumor
Estrogen secreting tumor
Stromal luteoma
Pregnancy luteoma
Luteal insufficiency pattern
Resistant ovary syndrome
Postmenopausal ovarian cyst hormonal
Menopausal ovarian fibrotic change

[Traumatic, post-surgical and iatrogenic]

Post oophorectomy remnant cyst
Ovarian remnant syndrome post-surgery
Post laparoscopy ovarian hematoma
Post-oocyte retrieval hematoma
Post IVF hyperstimulation OHSS severe
Post embolization ovarian necrosis
Post radiation fibrosis
Post chemotherapy cystic change
Post drainage residual cavity
Ovarian biopsy hematoma
Post cystectomy recurrence
Ovarian scar endometriosis
Adhesion-related fixation
Post ovarian torsion residual mass
Post hysterectomy residual cyst
Post pelvic surgery adhesion syndrome
Iatrogenic ovarian injury
Post ligation trophic cyst
Post oophoropexy ischemic change
Port site ovarian herniation

[Systemic, secondary and metastatic]

Krukenberg tumor gastric
Breast carcinoma metastasis
Colon carcinoma metastasis
Pancreatic carcinoma metastasis
Endometrial carcinoma extension
Cervical carcinoma extension
Lymphoma secondary
Leukemia infiltration
Melanoma metastasis
Lung carcinoma metastasis
Pseudomyxoma peritonei ovarian involvement
Peritoneal carcinomatosis (secondary ovarian seeding)
Appendiceal carcinoma metastasis
Retroperitoneal sarcoma invasion
Bladder carcinoma invasion
Renal cell carcinoma metastasis
Pelvic fibrosarcoma secondary infiltration
Ovarian metastasis from biliary tract carcinoma
Gastric linitis plastica secondary
Adrenal carcinoma metastasis

[Extraovarian and secondary (EC) causes ]

Pelvic abscess compressing ovary
Tubo ovarian complex TOC
Peritoneal inclusion cyst trapping ovary
Endometriotic adhesion fixing ovary
Bowel loop mimicking ovarian cyst
Appendiceal abscess adherent to ovary
Uterine fibroid compressing ovary
Broad ligament mass displacing ovary
Paraovarian adhesion (PID sequela)
Pelvic congestion with ovarian mimic vessels

ADNEXA

[Normal and physiological]

Normal fallopian tubes (not visualized)
Physiologic follicular activity (adjacent ovarian follicles)
Ovulatory changes (peri-ovulatory follicle rupture)
Small physiologic fluid in pouch of Douglas
Corpus luteum with peri-adnexal flow
Normal post-ovulatory pelvic fluid
Postpartum adnexa (normal involution)
Postmenopausal adnexa (atrophic structures)
Post-hysterectomy adnexal region (normal appearance)

[Tubal 9Fallopian Tube Lesion)]

Acute salpingitis
Chronic salpingitis
Pyosalpinx
Hydrosalpinx
Hematosalpinx
Tubo-ovarian abscess (TOA)
Tubo-ovarian complex (incomplete TOA)
Chronic tubo-ovarian mass
Pyosalpinx with septations
Hydrosalpinx with cogwheel sign
Tubal ectopic pregnancy (live)
Tubal ectopic (nonviable)
Interstitial (cornual) ectopic pregnancy
Isthmic ectopic pregnancy
Ampullary ectopic pregnancy
Fimbrial ectopic pregnancy
Tubal rupture with hemoperitoneum
Chronic ectopic with pseudomass
Tubal torsion
Tubal tumor (primary adenocarcinoma)
Metastatic tubal carcinoma
Tuberculous salpingitis
Parasitic (schistosomal) salpingitis
Post-surgical tubal stump cyst
Tubal remnant post-sterilization (hydrosalpinx)

[Paraovarian and paratubal cysts]

Simple paraovarian cyst
Multiloculated paraovarian cyst
Paraovarian cyst with hemorrhage
Paraovarian cyst with torsion
Paratubal cyst
Fimbrial cyst (of Morgagni)
Mesothelial inclusion cyst
Wolffian duct cyst (Gartner’s)
Broad ligament cyst
Hydatid cyst of Morgagni
Infected paraovarian cyst
Cyst with mural nodule (rare)
Endometriotic paraovarian cyst
Post-inflammatory inclusion cyst
Giant paraovarian cyst

[Adnexal masses — benign]

Endometrioma (in adnexa)
Hemorrhagic cyst (adnexal location)
Tubo-ovarian complex (resolving)
Dermoid cyst (adnexal)
Mature cystic teratoma
Paratubal benign tumor (adenofibroma)
Leiomyoma arising from broad ligament
Lipoleiomyoma (broad ligament)
Fibroma of broad ligament
Fibrothecoma (adnexal region)
Sclerosing stromal tumor (adnexal)
Pedunculated subserous fibroid (appearing adnexal)
Ovarian remnant with cystic change
Benign Brenner tumor (parovarian origin)
Serous cystadenoma (paraovarian extension)
Mucinous cystadenoma (paraovarian extension)
Benign hydatid cyst (parasitic)
Inflammatory pseudotumor (adnexal)
Mesenteric cyst mimicking adnexal mass
Benign mixed epithelial tumor

[Malignant and neoplastic adnexal masses ]

Serous cystadenocarcinoma (adnexal mass)
Mucinous cystadenocarcinoma (adnexal)
Endometrioid carcinoma involving adnexa
Clear cell carcinoma (extension to adnexa)
Borderline serous tumor (adnexal cystic-solid)
Borderline mucinous tumor
Krukenberg tumor (bilateral adnexal metastases)
Secondary metastasis (colon, stomach, breast)
Lymphoma (adnexal involvement)
Leukemia (secondary)
Sarcoma of broad ligament
Carcinosarcoma (extension into adnexa)
Primary peritoneal carcinoma (adnexal mass)
Ovarian carcinoma with peritoneal spread (adnexal implant)
Pseudomyxoma peritonei with adnexal deposits
Endometrial carcinoma with adnexal spread
Cervical carcinoma with adnexal extension
Metastatic melanoma (adnexal)
Malignant germ cell tumor (adnexal component)
Granulosa cell tumor (adnexal origin)
Sertoli–Leydig cell tumor (adnexal)
Mixed epithelial–stromal tumor
Undifferentiated carcinoma
Post-radiation sarcomatous change
Recurrent malignant adnexal mass

[Vascular and torsion]

Ovarian torsion
Paraovarian torsion
Tubal torsion
Broad ligament torsion
Ovarian vein thrombosis
Pelvic congestion syndrome (peri-adnexal varices)
Arteriovenous malformation (adnexal region)
Pelvic venous aneurysm
Hemorrhagic adnexal cyst rupture
Post-torsion infarction
Post-embolization necrosis
Ischemic adnexal mass
Ovarian hyperstimulation syndrome (adnexal congestion)
Hypervascular adnexal tumor
Peri-adnexal hematoma (traumatic or spontaneous)

[Traumatic, post-surgical and iatrogenic]

Post-tubal ligation hydrosalpinx
Tubal stump cyst
Ovarian remnant syndrome (after oophorectomy)
Post-hysterectomy adnexal mass (residual ovary or adhesions)
Post-cesarean adnexal hematoma
Post-oocyte retrieval hematoma
Post-IVF hyperstimulation (OHSS adnexal congestion)
Post-pelvic surgery adhesion complex
Post-endometriotic cyst drainage residual cavity
Post-laparoscopic trocar-site adnexal herniation
Iatrogenic tubo-ovarian fistula
Post-radiation adnexal fibrosis

[Congenital and developmental]

Congenital hydrosalpinx
Paramesonephric (Müllerian) duct cyst
Wolffian duct remnant cyst
Paratubal cyst (congenital)
Mesonephric duct remnant in broad ligament
Accessory ovary (ectopic)
Supernumerary adnexa
Duplicated fallopian tube
Unicornuate uterus with contralateral adnexal remnant
Adnexal herniation into inguinal canal (canal of Nuck)
Persistent embryonic ligament cyst
Müllerian remnant with cystic change
Fused tubo-ovarian complex (developmental)
Rudimentary uterine horn attached to adnexa
Tubal atresia
Hypoplastic ovary–tube complex
Heterotopic ovarian tissue in broad ligament
Accessory adnexal vascular channel
Ectopic adnexa (mesenteric location)
Developmental pelvic cyst (indeterminate origin)

[Systemic and secondary]

Endometriosis (systemic pelvic involvement)
Peritoneal carcinomatosis with adnexal deposits
Tuberculosis (pelvic TB with adnexal scarring)
Secondary metastasis from gastrointestinal tract
Secondary lymphoma
Leukemic infiltration
Pelvic inflammatory mass (secondary)
Adnexal edema (systemic heart failure)
Post-radiation pelvic fibrosis (secondary adnexal fixation)
Amyloidosis (adnexal involvement, rare)

[Extra-adnexal and secondary (ec) causes]

Uterine fibroid compressing adnexa
Ovarian tumor extending into adnexa
Cervical carcinoma invading broad ligament
Rectosigmoid carcinoma invading adnexa
Appendiceal abscess involving right adnexa
Pelvic abscess (non-gynecologic origin) compressing adnexa
Diverticulitis with adnexal inflammatory reaction
Peritoneal inclusion cyst encasing adnexa
Post-radiation pelvic adhesions tethering adnexa
Ureteral duplication cyst mimicking adnexal mass

[Peritoneal, ligamentous, and miscellaneous]

Broad ligament fibroid
Broad ligament cyst
Broad ligament leiomyosarcoma
Round ligament cyst
Round ligament varices (pregnancy-related)
Round ligament fibroma
Round ligament endometriosis
Mesenteric cyst (paraligamentous)
Omental cyst near adnexa
Peritoneal inclusion cyst
Pseudomyxoma peritonei with adnexal trapping
Pelvic adhesions (ligamentous)
Post-surgical peritoneal reaction
Pelvic sidewall fibrosis involving adnexa
Ligamentous vascular malformation

[Rare, complex, and multisystem ]

Adnexal metastasis from renal cell carcinoma
Adnexal metastasis from gallbladder carcinoma
Adnexal invasion from colon carcinoma
Adnexal extension of peritoneal mesothelioma
Adnexal abscess from appendicitis
Endometriosis with chocolate cyst adherent to adnexa
Tubercular abscess with calcified adnexa
Parasitic cyst (Echinococcosis in adnexal area)
Pelvic actinomycosis with adnexal fistula
Pelvic hydatid cyst involving adnexa
Broad ligament hydatid cyst
Post-surgical pseudocyst (encysted collection)
Chronic ectopic with organized clot
Chronic adhesive adnexal mass (post-PID)
Encysted peritoneal fluid collection around adnexa
Lymphocele (post-surgical, adnexal location)
Seroma (post-surgery)
Chronic hematocele mimicking adnexal mass
Peritoneal tuberculosis pseudotumor
Pelvic endosalpingiosis (rare epithelial inclusion)

FEMALE GROIN AND PERINEUM

Normal and physiological [10]

Normal Skene glands (small hypoechoic dots near urethra)
Normal perineal venous plexus (seen on Doppler)
Postpartum perineal thickening (physiologic edema)
Normal vulvar fat lobulation
Normal perineal scar (healed episiotomy)

Inflammatory and infective

Cellulitis of groin
Labial abscess
Vulvar abscess (Bartholin’s, Skene’s, or nonspecific)
Bartholin gland abscess
Skene gland abscess
Infected sebaceous cyst
Folliculitis / carbuncle of vulva
Hidradenitis suppurativa
Perineal abscess (postpartum or traumatic)
Perianal abscess (female)
Perineal phlegmon (ill-defined infection)
Necrotizing fasciitis (Fournier’s gangrene in female)
Vulvar cellulitis with gas (emphysematous infection)
Post-episiotomy wound infection
Post-laceration wound infection
Perineal sinus (post-episiotomy)
Post-fistulotomy abscess
Tuberculous vulvar abscess (rare)
Actinomycotic perineal infection
Fungal vulvovaginitis (ultrasound rarely used but thickening possible)
Chronic perineal inflammatory scarring
Post-radiation perineal infection
Traumatic infected hematoma
Parasitic infection (filarial equivalent — rare)
Vulvar phlegmon with perivascular spread

Cystic lesions

Bartholin gland cyst
Skene gland cyst
Gartner duct cyst (paraurethral)
Canal of Nuck cyst (female hydrocele)
Epidermoid cyst (labial or perineal)
Dermoid cyst (rare in groin)
Inclusion cyst (post-surgery or episiotomy)
Post-traumatic cyst (liquefied hematoma)
Subcutaneous seroma (post-surgery)
Urethral diverticulum (cystic periurethral lesion)
Paraurethral cyst (non-communicating)
Peri-clitoral cyst
Vulvar mucous retention cyst
Vulvar lymphangioma cystic variant
Post-suture inclusion cyst
Post-hysterectomy lymphocele (groin extension)
Infected Bartholin cyst
Infected paraurethral cyst
Giant Bartholin cyst (rarely >5 cm)
Multiloculated perineal cystic lesion

Solid benign lesions

Lipoma of groin/labia
Angiolipoma
Fibroma
Leiomyoma (vulvar / perineal)
Myofibroma
Schwannoma
Neurofibroma
Granular cell tumor (vulvar)
Desmoid fibromatosis
Endometrioma (vulvar/perineal scar endometriosis)
Post-episiotomy scar endometriosis
Angiomyofibroblastoma (benign myxoid tumor)
Cellular angiofibroma (vulvar mass)
Hemangioma
Lymphangioma
Ectopic mammary tissue nodule (groin)
Heterotopic vulvar sebaceous adenoma
Benign mixed tumor (adenomyoepithelioma)
Hypertrophic scar nodule
Reactive fibrous nodule (post-suture granuloma)

Malignant lesions

Squamous cell carcinoma (vulva/perineum)
Basal cell carcinoma (labia majora)
Malignant melanoma of vulva
Adenocarcinoma of Bartholin gland
Adenocarcinoma of Skene gland
Sarcoma (leiomyosarcoma / rhabdomyosarcoma)
Angiosarcoma
Lymphoma involving vulva
Metastasis to groin (ovarian, cervical, colorectal)
Paget’s disease of vulva (echogenic thickening)
Vulvar intraepithelial neoplasia (VIN)
Malignant granular cell tumor
Clear cell carcinoma (rare)
Adenosquamous carcinoma
Carcinoma invading perineum from vagina
Carcinoma invading perineum from rectum
Recurrent carcinoma post-vulvectomy
Post-radiation sarcoma
Cutaneous metastasis from breast or colon
Merkel cell carcinoma (rare skin malignancy)

Vascular and lymphatic

Vulvar varicosities (common in pregnancy)
Perineal varices
Round ligament varices (groin)
Great saphenous vein varix near groin
Superficial epigastric vein dilation
Venous malformation (labial)
Arteriovenous malformation (AVM)
Postpartum perineal varices
Hemangioma (superficial vascular mass)
Cavernous hemangioma (deep)
Lymphangioma circumscriptum (vulvar)
Lymphocele (post-surgical groin)
Lymphatic fistula
Lymphangiectasia (post-radiation or post-infection)
Postpartum vulvar edema (vascular congestion)
Arterial pseudoaneurysm (post-episiotomy)
Perineal hematoma (vascular rupture)
Ischemic necrosis (severe torsion or trauma)
Pelvic congestion syndrome with perineal reflux
Post-embolization vascular change

Hernial and fascial defects

Inguinal hernia (female)
Femoral hernia
Obturator hernia (rare)
Spigelian hernia extending to groin
Canal of Nuck hernia
Round ligament hernia
Incisional hernia (lower abdominal scar)
Recurrent groin hernia
Strangulated groin hernia
Hernia containing ovary or fallopian tube
Hernia containing bowel loops
Hernia with bladder wall extension
Umbilical hernia extending inferiorly
Post-surgical hernia at Pfannenstiel incision
Preperitoneal fat herniation (pseudo-mass)

Traumatic, obstetric and post-surgical

Post-episiotomy hematoma
Post-delivery perineal tear (Grade I–IV)
Postpartum vulvar hematoma
Postpartum perineal hematoma (deep pelvic floor)
Post-vacuum or forceps delivery soft tissue injury
Post-cesarean groin seroma
Post-hysterectomy groin swelling (lymphocele)
Post-laparoscopic trocar-site hematoma (groin)
Perineal tear dehiscence
Rectovaginal fistula
Vesicovaginal fistula
Perineovaginal fistula
Rectoperineal fistula
Urethroperineal fistula
Post-suture abscess
Post-episiotomy fibrosis / scar
Post-Bartholin excision residual cavity
Post-surgery neuroma (painful nodule)
Post-episiotomy endometriosis
Post-radiation perineal fibrosis
Perineal foreign body granuloma
Post-surgical sinus tract
Post-traumatic fat necrosis
Perineal wall dehiscence with infection
Episiotomy scar defect (subcutaneous cavity)

Congenital and developmental

Canal of Nuck cyst
Persistent processus vaginalis (female hydrocele)
Labial fusion anomaly
Imperforate hymen (urinary retention, bulge)
Congenital urethral diverticulum
Urethral cyst (infantile)
Ectopic urethra opening (epispadias variant)
Congenital perineal fistula
Cloacal anomaly (common channel)
Duplicated urethra / vagina with perineal tract
Congenital inclusion cyst
Accessory mammary tissue (labial)
Accessory vulvar gland
Ectopic ovary in groin (developmental)
Congenital lymphangioma

Systemic and secondary

Edema (cardiac/renal failure)
Hypoproteinemia-induced vulvar edema
Elephantiasis (filariasis)
Crohn’s disease perineal involvement
Ulcerative colitis perineal sinus
Radiation proctitis with perineal spread
Leukemia or lymphoma infiltration
Diabetic infection (necrotizing fasciitis risk)
SLE perineal vasculitis
Amyloidosis of vulva (rare)

Urogynecologic and pelvic floor disorders

Cystocele (anterior vaginal wall prolapse)
Rectocele (posterior vaginal wall prolapse)
Enterocele (herniation of small bowel into pouch of Douglas)
Vault prolapse (post-hysterectomy)
Perineal body descent
Pelvic floor laxity (levator hiatus widening)
Perineal scar defect post-episiotomy
Urethral hypermobility
Urinary stress incontinence (visible bladder neck descent)
Fecal incontinence (anal sphincter thinning)
Anal sphincter tear (3rd/4th degree)
Obstetric anal sphincter injury (OASIS)
Pelvic floor dyssynergia
Perineal descent syndrome
Post-sling surgery scarring

Extra-groin and secondary (ec) causes

Pelvic abscess tracking to perineum
Appendiceal abscess extending to groin
Diverticular abscess to perineum
Colorectal carcinoma invading perineum
Cervical or vaginal carcinoma extending into perineum
Urethral carcinoma extending distally
Bladder carcinoma invading anterior perineum
Retroperitoneal mass compressing groin
Lymph node metastasis (inguinal)
Soft tissue metastasis (melanoma / ovarian carcinoma)

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End of Topic

You have reached the end of this First-Trimester Ultrasound topic.

Content is intended for educational, training, and clinical reference only.

Declaration:
I, R. K. Mouj, declare that the material presented in this Pelvis Ultrasound (Female) report template has been prepared solely for educational and academic purposes. Any measurements, descriptions, or example findings provided are illustrative in nature. Clinical correlation, relevant laboratory investigations, follow-up imaging, and professional clinical judgment are essential before making diagnostic or management decisions.

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