Wk 4, Case 4 - Review

PATIENT HISTORY: Bilious emesis

CT abdomen and pelvis intravenous contrast.

INDICATION: Bilious emesis.

COMPARISON: None.

TECHNIQUE: CT images of the abdomen and pelvis were obtained after the administration of intravenous contrast.


FINDINGS:

Lung bases: Atelectatic changes are present at the lung bases.

Hepatobiliary: There is indeterminate left hepatic hypodensity. A linear hypodensity at the right hepatic dome is also nonspecific, though of doubtful significance. Nonspecific high density content the gallbladder may represent sludge/stones. No biliary ductal dilatation is seen.

Pancreas: Unremarkable.

Spleen: Status post splenectomy.

Adrenal glands: Unremarkable.

Kidneys: A few hypodensities are present, some of which are cysts while others are too small to characterize.

Bowel: There are findings compatible with a closed-loop small bowel obstruction, with two zones of transition seen in the left lower quadrant in close proximity to one another. No pneumatosis seen.

Abdominal and pelvic lymph nodes: No lymphadenopathy.

Peritoneum: Minimal interloop fluid/edema is noted associated with a closed-loop bowel obstruction. Small amount of free fluid is seen elsewhere in the upper abdomen. No free air or abscess identified. No portal venous gas identified.

Vasculature: No abdominal aortic aneurysm.

Pelvis: No mass.

Musculoskeletal system and soft tissue: No aggressive osseous lesion.


IMPRESSION:

Closed loop small bowel obstruction as described.