Wk 5, Case 3 - Review

PATIENT HISTORY: Abdominal distention

Study: CT abdomen pelvis with intravenous contrast.

Indication: Abdominal distention.

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

FINDINGS:

Lung bases: Scarring/atelectatic changes are present at the lung bases. A 3.1 cm mass at the right lower lobe is nonspecific though may represent rounded atelectasis. Dedicated CT scan of the chest is suggested for further evaluation.

Hepatobiliary: There is a left hepatic hypodensity too small to characterize.

Gallbladder is unremarkable. No biliary ductal dilatation.

Pancreas: Unremarkable.

Spleen: A 1.4 cm splenic hypodensity is nonspecific though doubtful clinical significance.

Adrenal glands: Unremarkable.

Kidneys: Right renal cyst is noted with additional renal hypodensities too small to characterize.

Bowel: There is marked distention of the sigmoid colon with rapid tapering at the level of the pelvic inlet or swirling of the mesentery and vessels in this location are noted. These findings are compatible with sigmoid volvulus. Small hiatal hernia is noted.

Abdominal and pelvic lymph nodes: No lymphadenopathy.

Peritoneum: Minimal free fluid is noted adjacent to the small hiatal hernia.

Vasculature: No abdominal aortic aneurysm. The common, external and internal iliac veins are diminutive in caliber with some of these containing calcifications compatible with chronic thrombus; associated venous collaterals are noted in the anterior pelvic wall.

Pelvis: A suprapubic catheter is noted terminating in the bladder.

Musculoskeletal system and soft tissue: No aggressive osseous lesion.

IMPRESSION:

Sigmoid volvulus.