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Transvaginal ultrasound has improved the ability of ultrasound to interrogate the pelvic organs with less interference from intervening structures such as gas or fat. The gynaecologist may need to distinguish between the symptoms caused by pelvic inflammatory disease and those of an inflamed pelvic appendix. Appendiceal mucocele occurs when there is accumulation of mucoid material within the lumen of the appendix distal to an obstruction. Mucoceles occur more commonly in women than men. Ultrasound can show different patterns, including a cystic structure with thin walls, a cyst with septations and, the most common appearance, layered rings of mucus of different echogenicity. Ultrasound is highly sensitive in detecting calculi in the kidneys. An ureterocele can be clinically silent and without upper tract dilation. The diagnosis may be made for the first time during sonography of the pelvis.
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