Demographics:
66 years old, Female
Indication:
Generalized abdominal pain
Findings
Lower chest
- Mild dependent atelectasis
- Moderate right pleural effusion
- Cardiomegaly
- Mitral annular calcification
- Small hiatal hernia
Abdomen/Pelvis
- Short segment of small bowel protrudes through a narrow-necked left ventral abdominal wall hernia with fluid in the hernia sac
- Extensive small bowel pneumatosis and mild dilation
- Extensive portomesenteric venous gas
- Surgical changes of sigmoidectomy
- Cholelithiasis
- Multiple low-attenuation structures in the spleen, with the largest measuring 4.5 cm and containing thin internal septations
- Bilateral renal atrophy
- 4 cm exophytic low density structure arising from the lower pole of the left kidney with thick walls
- Additional scattered bilateral renal hypodensities are too small to characterize
- Nonobstructing right renal calculi measuring up to 12 mm in the upper pole
- Small volume ascites
- Diffuse mesenteric edema
- Multiple calcified uterine fibroids
- Extensive atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
- IVC filter proximal tip below the level of the renal veins
MSK
- No acute osseous findings
- Polyarticular degenerative changes
- Body wall edema
Diagnosis
Small bowel ischemia due to obstructing hernia
Sample Report
Findings concerning for small bowel obstruction due to a left ventral abdominal wall hernia with associated extensive bowel ischemia.
Likely complex cystic lesion arising from the lower pole of the left kidney. Recommend nonemergent renal mass protocol MRI for further evaluation.
Findings suggestive of volume overload including moderate right pleural effusion, small volume ascites, diffuse mesenteric edema, and body wall edema.
Discussion