Demographics:
71 years old, Male
Indication:
Abdominal pain and skin drainage
Findings
Lower chest
- Mild dependent atelectasis/scarring
- Coronary artery atherosclerosis
- Mildly patulous distal thoracic esophagus
Abdomen/Pelvis
- Close apposition of multiple small bowel loops to the ventral abdominal wall suggesting the presence of adhesions
- Contrast material in a tract extending from a small bowel anastomosis in the mid ventral abdomen to the abdominal wall and layering in a large ventral abdominal wall wound
- Additional more superior tracts extending from this anastomosis into the adjacent abdominal wall musculature
- Multiple hepatic cysts and subcentimeter hypoattenuating lesions which are too small to characterize
- Cholelithiasis
- Minimally complex right renal cyst
- Atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
MSK
- No acute osseous findings
- Polyarticular degenerative changes
- Focal stranding in the lateral right ventral abdomen (this was a site of recent percutaneous drainage)
Diagnosis
Enterocutaneous fistula
Sample Report
Enterocutaneous fistula arising from a small bowel anastomosis in the mid ventral abdomen with adjacent complex sinus tracts.
No bowel obstruction.
Discussion