Demographics:
65 years old, Male
Indication:
Nausea, vomiting
Findings
Lower chest
- Mild dependent atelectasis
- Mild circumferential mucosal thickening of the lower thoracic esophagus
Abdomen/Pelvis
- Pneumobilia with intraluminal air in the gallbladder, which is nondistended
- Gallbladder wall thickening with pericholecystic fluid and loss of the normal fat plane between the gallbladder and duodenum
- Distended, fluid-filled loops of proximal and mid small bowel measuring up to 4.5 cm in diameter with transition point in the right lower quadrant where there are several peripherally calcified intraluminal structures
- Colonic diverticulosis
- 3 cm left adrenal nodule measuring less than 10 HU compatible with an adenoma
- 6.5 cm fluid density structure arising exophytically from the interpolar left kidney, consistent with a cyst
- Additional bilateral subcentimeter renal hypoattenuating lesions, which are too small to characterize
- Small right posterolateral bladder diverticulum
- Prostatomegaly
- Mild atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
MSK
- No acute findings
- Multilevel spine degenerative changes, most pronounced at L5-S1
Diagnosis
Gallstone ileus
Sample Report
Findings concerning for acute cholecystitis complicated by gallstone ileus with several gallstones in the distal small bowel and mild upstream small bowel dilation. Recommend surgical evaluation.
Mild circumferential thickening of the lower thoracic esophagus, which can be seen with esophagitis.
Left adrenal adenoma.
Discussion