Demographics:
72 years old, Female
Indication:
Abdominal pain and distension
Findings
Lower chest
- Small hiatal hernia
- Trace pericardial effusion
- Pleural-based 5 mm left lower lobe pulmonary nodule
- Mild bilateral lower lobe and lingular scarring/atelectasis
Abdomen/Pelvis
- Marked diffuse colonic distension measuring up to 9.7 cm in diameter without definite transition point or mural thickening
- Small bowel is normal in caliber
- Diffuse pancreatic atrophy
- Adreniform thickening of the left adrenal gland without discrete nodule
- Intermediate attenuation 1.5 cm exophytic lesion arising from the medial upper pole of the left kidney
- Atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
- Bladder is decompressed around a Foley catheter
MSK
- No acute osseous findings
- Polyarticular degenerative changes
- Mild body wall edema
Diagnosis
Ogilvie syndrome
Sample Report
Marked diffuse colonic distension without transition point or obstructing mass identified, which is primarily concerning for colonic pseudo-obstruction (Ogilvie syndrome). The absence of a transition point makes large bowel obstruction very unlikely.
Indeterminate left upper pole renal lesion for which nonemergent renal ultrasound is recommended.
5 mm left lower lobe pulmonary nodule. Consider 12 month follow-up chest CT if the patient is at increased risk for pulmonary malignancy.
Discussion