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Target like (bulls eye) appearance, central hyperechoic and outer hypoechoic ring. 5 layers: mucosa (hyper), muscularis mucosa (hypo), submucosa (hyper), muscularis propria (hypo), adventitia serosa (hyper).

Bowel wall thickening

Pseudomyxoma peritonei

Mucinous implants and gelatinous peritoneal fluid arising from mucinous tumors of the ovary, GI tract (appendix). From loculated, anechoic fluid collections w/ mass effect through septated collections w/ or w/o internal echoes to more echogenic masses w/ or w/o calcs. Mesothelioma can mimic peritoneal carcinomatosis and tuberculous peritonitis (not pseudomyxoma).

Abdominal wall

Rectus sheath hematoma: Lenticular complex fluid collections.

Mets: Hypoechoic or complex solid or cystic masses.

DDx: Desmoid tu, Endometrioma, Lymphoma, Lipoma, Hematoma, Abscess


Inflammatory, Infectious or Neoplastic.

Aortic aneurysm

95% below renal arteries, normal aortic diameter: 2.5 cm at the diaphragm, 2.0 cm in the midabdomen, 1.8 cm at the bifurcation; Aneurysm > 3 cm, Ectasia < 3 cm, Surgery > 5 cm, Fusiform, if Saccular think mycotic or pseudoaneurysm.


Thrombus usually extends from iliac, renal, hepatic or gonadal veins. Ovarian vein thrombosis is postpartum complication, occurs on the right side and is associated w/ endometritis.