Demographics:
68 years old, Male
Indication:
Abdominal pain and fever after recent umbilical hernia ...
Abdominal pain and fever after recent umbilical hernia repair
Findings
Lower chest
- Mild dependent atelectasis
- Small left pleural effusion
- Coronary artery calcification
Abdomen/Pelvis
- Numerous dilated loops of small bowel with extensive pneumatosis involving the proximal jejunum through mid/distal ileum
- Extensive portal venous gas in the small bowel mesentery and liver
- Nodular hepatic surface contour
- Cholelithiasis
- Splenomegaly
- Recent surgical changes of laparotomy for umbilical hernia repair with small volume pneumoperitoneum and ascites
- Enteric tube terminates in the proximal jejunum
- Colonic diverticulosis
- Mural thickening of the ascending and transverse colon
- Atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
- Splenorenal varices
- Recanalized paraumbilical vein with intraluminal gas
- Urinary bladder is decompressed around a Foley catheter
MSK
- No acute osseous findings
- Multilevel anterior bridging osteophytosis in the spine as can be seen with diffuse idiopathic skeletal hyperostosis (DISH)
- Gynecomastia
Diagnosis
Pneumatosis
Portal venous gas
Sample Report
Findings concerning for bowel ischemia involving the proximal jejunum through mid to distal ileum. Associated extensive pneumatosis and portal venous gas.
Recent surgical changes of umbilical hernia repair with small volume pneumoperitoneum likely postoperative in etiology.
Stigmata of cirrhosis and portal hypertension.
Discussion