Demographics:
71 years old, Male
Indication:
Abdominal pain, anemia
Findings
Chest
- Mild dependent airspace consolidation in the left lower lobe and lingula
- Status post CABG and aortic valve replacement
- Heavy coronary artery calcification
- Thoracic aortic atherosclerosis without aneurysm
- Right upper extremity PICC with tip at the superior cavoatrial junction
Abdomen/Pelvis
- No acute findings
- Cholecystectomy
- 4 cm right upper pole renal cyst and additional bilateral subcentimeter hypoattenuating lesions, which are too small to characterize
- Colonic diverticulosis
- Percutaneous gastrostomy tube with retention balloon in the gastric antrum
- Small amount of fluid tracking about the gastrostomy tube to the ventral abdominal wall
- 3 cm lipoma at the junction of the cecum and ascending colon
- Urinary bladder is decompressed around a Foley catheter
- Atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
- IVC filter with proximal tip below the level of the renal veins
MSK
- Asymmetric enlargement and increased attenuation of the left obturator internus muscle with adjacent fat stranding
- Subcutaneous nodularity in the lower abdominal/pelvic wall likely relating to medication injections
- Asymmetric left flank soft tissue edema
- Lower ventral abdominal wall laparotomy scar
- Bilateral L5 pars defects with grade 1 anterolisthesis of L5 on S1
- Dorsal column stimulator with leads ascending to the level of T8
Diagnosis
Obturator internus intramuscular hematoma
Sample Report
Left obturator internus intramuscular hematoma with a small amount of adjacent retroperitoneal hemorrhage. No evidence of adjacent bony trauma.
Asymmetric left flank edema could relate to patient positioning or could be traumatic in etiology.
Small amount of fluid leaking around the patient’s gastrostomy tube.
Dependent airspace disease in the left lower lobe and lingula, which raises concern for aspiration or pneumonia.
Discussion