Bilateral tubal pregnancy (BTP) is a very rare form of ectopic twin gestation. Many times, they occur after the use of assisted reproductive therapy. Most cases of BTP are diagnosed during laparoscopy. This case report demonstrates a rare preoperative, sonography diagnosis of a spontaneous BTP which occurred after a tubal ligation. The sonogram revealed two corpus luteal cysts, both located on the right ovary, which suggests that the left tubal pregnancy most likely occurred as a result of ovum transmigration. This case demonstrates the important role that sonography plays in the early diagnosis of ectopic pregnancies as well as the importance of thoroughly examining the entire pelvis during a pelvic sonogram.
Zenker diverticulum is the most common type of esophageal diverticulum. It is located in a natural area of weakness on the posterior pharyngeal wall, in an area known as the Killian triangle. 1 Although Zenker diverticulum is a posterior structure, if large enough, it may project to the left side of the neck. They often appear in close proximity to the left thyroid, 2,3 as presented in this case.
Portal vein tumor thrombus (PVTT) is a complication of liver disease, specifically hepatocellular carcinoma (HCC). It occurs secondary to direct invasion of tumor into the portal venous system. PVTT is associated with a poor prognosis, therefore identification and differentiation of malignant from benign thrombus is very important in the treatment of the patient. Sonography can be a useful tool in the detection of malignant thrombus.
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