Demographics:
62 years old, Male
Indication:
Lower abdominal pain, anemia
Findings
Lower chest
- Large right and small left pleural effusions with overlying atelectasis
- Scattered calcified granulomas
- Mitral valve prosthesis
- Coronary artery calcification
- Low attenuation of the unenhanced blood pool suggestive of anemia
Abdomen/Pelvis
- Large, mixed attenuation right retroperitoneal collection measuring 15 x 10 x 17 cm with a hematocrit level and surrounding fat stranding
- Thickening of the posterior limb of Gerota's fascia on the right
- Scattered subcentimeter hepatic hypoattenuating lesions, which are too small to characterize, and calcified granulomas
- Layering gallbladder sludge and/or small stones without gallbladder distension, wall thickening, pericholecystic inflammatory changes, or biliary duct dilation
- Mild diffuse fatty atrophy of the pancreas without duct dilation or focal lesion identified
- Anterior displacement of the right kidney with a subcentimeter hypoattenuating structure in the anterior interpolar region, which is too small to characterize
- Nonobstructing 3 mm left interpolar renal calculus
- Circumferential mural thickening of the urinary bladder
- Small volume abdominopelvic ascites
- Atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
- Vas deferens calcifications, which are typically seen in the setting of diabetes mellitus
MSK
- Right iliacus and left psoas intramuscular hematomas
- Body wall edema
- Remote bilateral anterior rib fractures
- Bilateral L5 pars defects with grade 1 anterolisthesis of L5 on S1
- Polyarticular degenerative changes
- Ankylosis of both sacroiliac joints
Diagnosis
Retroperitoneal hematoma
Sample Report
Large acute right retroperitoneal hematoma which results in anterior displacement of the right kidney. Unable to assess for active hemorrhage in the absence of IV contrast material.
Smaller acute right iliacus and left psoas intramuscular hematomas.
Findings suggestive of volume overload/third spacing including large right and small left pleural effusions, small volume ascites, and body wall edema.
Circumferential bladder wall thickening, out of proportion to underdistension. Recommend correlation with urinalysis for signs of cystitis.
Discussion