Demographics:
61 years old, Female
Indication:
Diffuse abdominal pain
Findings
Lower chest
- No acute findings
- Low attenuation left breast lesion
Abdomen/Pelvis
- Displaced loop of small bowel in the right lower quadrant with mild distension (measuring up to 3.5 cm in diameter) and mural thickening and hypoenhancement
- No pneumatosis or portal venous gas
- Two transition points are noted involving the afferent and efferent bowel segments, which are in close proximity to each other
- Additional mildly dilated loops of small bowel in the left lower quadrant without mural hypoenhancement or defined transition point
- Surgical changes of Roux-en-Y gastric bypass
- Small to moderate volume free intraperitoneal fluid, including right lower quadrant interloop fluid, without loculated collection or free air
- 1 cm left renal cyst
- Hysterectomy
- Minimal atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
MSK
- No acute findings
- Polyarticular degenerative changes
Diagnosis
Closed-loop small bowel obstruction
Sample Report
Findings concerning for closed-loop small bowel obstruction in the right lower quadrant, likely related to an internal hernia in the setting of prior Roux-en-Y gastric bypass.
No pneumatosis, portal venous gas, or pneumoperitoneum.
Small to moderate volume ascites, likely reactive, without loculated collection.
A low attenuation left breast lesion may represent cystic change, but is incompletely characterized. Recommend correlation with mammography.
Discussion