A teenage girl was admitted to the Children's City Clinical Hospital with suspicion of appendicitis, dystrophy - a sunken abdomen, costal spaces, etc. Complains of pain below the umbilicus in the midline of the abdomen.
From the ED she was sent for an ultrasound.
Ultrasound data for appendicitis was not found.
In the lower half of the abdomen there is a predominantly fluid mass, further interpreted as (complex) ascites, with multiple parietal echogenic inclusions of uneven / mysterious shape, of different sizes, which most likely represent disseminates of the peritoneum (differential diagnosis - pseudomyxoma / carcinomatosis).
In the right iliac region in the projection of the anterior abdominal wall, there is a delimited compartment into which an intestinal loop enters, most likely a hernia.