Free Fluid/Ascites

1. Introduction 100%

Definition and Clinical Importance of Free Fluid
Indications for Ultrasound Detection of Ascites
Differential Diagnosis: Transudate vs Exudate
Role in Emergency, ICU, and Oncology Settings

2. Relevant Anatomy & Fluid Spaces 80%

Peritoneal Compartments: Supramesocolic, Inframesocolic
Morrison’s Pouch (Hepatorenal Space)
Pouch of Douglas (Rectouterine/Rectovesical)
Paracolic Gutters and Subphrenic Spaces
Retroperitoneal Compartments (Differentiation)

3. Scanning Technique and Patient Prep 100%

Patient Positioning (Supine, LLD, RLD)
Probe Selection: Curvilinear 3–5 MHz
Use of Sweep and Fan Motion
Real-Time Graded Compression
Dynamic Shifting with Position Change

4. Normal and Abnormal Sonographic Findings 50%

Anechoic Free Fluid (Simple Ascites)
Septations, Debris, Loculations (Complex Ascites)
Fluid Between Bowel Loops and Liver Surface
Volume Estimation: Minimal, Moderate, Massive

5. Types and Causes of Ascites

1. Transudative Ascites

Cirrhosis with Portal Hypertension
Nephrotic Syndrome
Heart Failure

2. Exudative Ascites

Tuberculous Peritonitis
Malignant Ascites (Carcinomatosis)
Pancreatic Ascites
Post-surgical Collections

3. Hemoperitoneum and Urinary Ascites

Trauma-related Bleeding
Ruptured Ectopic Pregnancy
Post-procedural Complications
Urinoma / Bladder Rupture

6. Ultrasound-Guided Interventions 0%

Diagnostic Paracentesis
Therapeutic Tapping of Ascites
Site Selection and Needle Guidance
Complications and Post-Procedure Follow-up

7. Advanced Modalities and Comparison 0%

CT vs Ultrasound in Detecting Fluid Collections
MRI Features of Complex Ascites
Contrast-Enhanced Ultrasound (CEUS) in Malignant Ascites
Role of Elastography in Cirrhotic Ascites

8. Case Studies and Quiz Section 0%

Ascites with Cirrhosis
Malignant Peritoneal Disease
Ectopic Pregnancy with Hemoperitoneum
Spot Diagnosis: Image-Based Quiz Questions