Describe the characteristics of the "Ring-down" artifact, its meaning and its proper interpretation. Present the expected (physiological) and unexpected locations (pathologies) most frequent in which this sign is identified, the appropriate ultrasonographic technique and the importance in urgency. Perform a review of simulative images that make diagnosis difficult, during the ultrasonographic examination and how to identify them.

Ultrasoundis widely recognized as a tool in bedside diagnosis in patients with emergency pathology, especially in the acute abdomen (1,2) . Initial evaluation of the peritoneal patient often includes a bedside FAST exam to document the presence of free fluid (3) . Traditional teaching highlights the diagnostic utility of free fluid, as a significant finding (Search for an aortic aneurysm or broken ectopic pregnancy) and as a desirable complement for better ultrasonographic imaging (such as...

To learn to appreciate the presence of pathological air, we must first learn to recognize the physiological air , especially that found in the gastrointestinal tract and in the lung parenchyma. ( Fig. 3 ) However, the pathological air can be found in different regions, therefore, its search and study should focus on clinical suspicion. PATHOLOGICAL DISTRIBUTION OF AIR: ( Fig. 4 ) Extraluminal free air: ⇒ Intra-abdominal ⇒ Retro-peritoneal Intraluminal air in preformed structures. The air of...

The Ringdown Artifact , generally tolerated as a necessary evil usually present in the intestinal/pulmonary region, can in expert hands become a great tool when evaluating the patient with urgent, even vital pathology. It's finding in certain locations, the appropriate interpretation and the relationship in the clinical context of the patient can turn our old and routine examination into a complete experience where the objective is to establish a reliable definitive diagnosis in a matter of...

Contac Details : Dr. Gustavo Averanga Resident in training. Departament of Radiology. Hospital of Trauma and Emergencies "Dr. Federico Abete" Pablo Nogues, Bueno Aires-Argentina. Email : gustavo.averanga.t@gmail.com Dra. Zulmara Figueroa Dra. Grettel Leal Residents in training.Diagnostic ImagingDepartment. Hospital of Trauma and Emergencies "Dr. Federico Abete" Pablo Nogues, Bueno Aires-Argentina. Dra. Paola Yuly Narváez Chief of Residents.Diagnostic ImagingDepartment. Hospital of Trauma and...

1. American College of Emergency Physicians. ACEP Ultrasound Guidelines 2008. Available at www.acep.org/ content.aspx?id = 32182 2. Unlu ̈er EE, Yavasi O, Erog ̧ ̆ lu O, Yilmaz C, Akarca FK. Ultrasonography by emergency medicine and radiology residents for the diagnosis of small bowel obstruction. Eur J Emerg Med 2010. 3. Hoffmann, B., Nürnberg, D., y Westergaard, MC (2012). Centrarse en el aire anormal. Revista Europea de Medicina de Emergencia, 19 (5), 284-291. 4. Seitz K, Reising KD....