The Abdominal Jellyfish Sign: An Ultrasonographic Approach for Diagnosing Abdominal Collections — A Case Report

Abstract

Ultrasound has become a valuable tool for detecting fluid accumulations due to its ability to reveal the nature of the fluid based on its appearance and anatomical location. This case report explores the use of ultrasound in diagnosing an abdominal collection suggestive of peritonitis by introducing an ultrasonographic dynamic sign. A 37-year-old patient, post-rectal tumor surgery, presented with abdominal pain, peritoneal reaction, and clinical deterioration necessitating intensive care. Point-of-care ultrasound revealed a hyperechoic, mobile, image with septa resembling a jellyfish in the subhepatic region, indicating a complicated fluid collection. Abdominal CT confirmed the presence of free fluid in perihepatic and left subphrenic regions. Subsequent surgery revealed peritonitis, anastomosis suture dehiscence, and successful management in the ICU. Recognizing the “abdominal jellyfish sign” and interpreting it appropriately within the relevant clinical context aids in the diagnosis of complicated abdominal collections. Further studies employing alternative methodologies will be necessary to confirm or refute the true significance of this sign in this context.