Demographics:
88 years old, Female
Indication:
Generalized abdominal pain
Findings
Lower chest
- Dependent right lower lobe consolidation
- Small pericardial effusion
- Aortic root calcification
Abdomen/Pelvis
- Multiple mildly dilated loops of fluid-filled small bowel in the central abdomen measuring up to 3 cm in diameter with extensive mural edema and relative hypoenhancement
- Associated mesenteric edema and mesenteric swirling
- Normal appearing small bowel proximal and distal to these involved loops
- Extensive colonic diverticulosis
- Multiple subcentimeter hepatic hypoattenuating lesions, which are too small to characterize
- Bilateral renal cysts and additional subcentimeter hypoattenuating lesions, which are too small to characterize
- Small volume free abdominopelvic fluid without loculated collection
- 3.5 x 2.5 cm soft tissue attenuation structure in the posterior perirectal space which does not clearly arise from the adjacent bowel
- Atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
- Circumaortic left renal vein
MSK
- No acute findings
- Multilevel degenerative changes of the spine with stepwise anterolisthesis from L3-L5
Diagnosis
Closed-loop small bowel obstruction
Sample Report
Findings concerning for closed-loop small bowel obstruction and possible developing ischemia. No pneumatosis, portal venous gas, or pneumoperitoneum. Recommend surgical evaluation.
Small volume abdominopelvic free fluid without loculated collection.
Soft tissue attenuation structure in the perirectal space of unclear origin. This can be further evaluated with nonemergent pelvic MRI.
Dependent airspace opacification in the right lower lobe may relate to atelectasis and/or aspiration.
Discussion