Age: 78
Sex: Male
Indication: Tarry stools, syncope
Save ("V")
Case #21
Findings
- Lower chest
- Advanced destructive emphysema
- Heavy coronary artery calcification
- Abdomen/Pelvis
- Colo-colonic intussusception at the splenic flexure measuring 10 cm in length with a 3.5 x 2.5 cm mass at the distal margin of the intussusceptum
- Edematous appearance of the intussusceptum
- Colonic diverticulosis
- Hepatomegaly
- Multiple circumscribed fluid attenuation hepatic lesions, likely cysts
- Focal fatty infiltration in the liver adjacent to the falciform ligament
- 7 mm hypodense lesion with associated calcification in the pancreatic head
- Focal mural thickening at the gallbladder fundus compatible with adenomyomatosis
- Mild fullness of both renal collecting systems
- Bilateral subcentimeter renal hypodensities which are too small to characterize
- Small volume ascites around the liver extending into the right paracolic gutter and into the anatomic pelvis
- Distended urinary bladder
- Prostatomegaly with nonspecific prostatic calcification
- Atherosclerotic calcification of the abdominal aorta and branch vessels with fusiform ectasia of the infrarenal abdominal aorta measuring 2.5 cm in AP diameter
- MSK
- No acute osseous findings
- Polyarticular degenerative changes
- Body wall edema
Diagnosis
- Malignant colo-colonic intussusception
Sample Report
Colo-colonic intussusception at the splenic flexure measuring 10 cm in length with edema and possible early ischemic changes of the intussusceptum. Mass at the distal margin of the intussusceptum is concerning for a neoplastic lead point. Recommend surgical evaluation.
Small volume free intraperitoneal fluid, likely reactive to the intussusception.
Findings of chronic bladder outlet obstruction related to prostatomegaly with mild fullness of both renal collecting systems.
7 mm partially calcified lesion in the pancreatic head. Recommend correlation with prior imaging, if available, to document stability. If no prior imaging is available, recommend followup pancreatic protocol CT or MRI in 2 years.
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