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Case #76

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Demographics: 50 years old, Male
Indication: Generalized abdominal pain

Case #76

Findings

Lower chest

  • No acute findings

Abdomen/pelvis

  • Ileocolic intussusception extending to the hepatic flexure with upstream mild dilation of multiple fluid-filled loops of small bowel, measuring up to 4.2 cm in diameter
  • Small left lateral ventral abdominal wall hernia (Spigelian hernia) containing a short segment of small bowel and a small amount of peritoneal fluid
  • Small right inguinal hernia containing a small amount of peritoneal fluid
  • Close apposition of multiple loops of small bowel to the ventral abdominal wall, suggestive of chronic adhesions
  • Cholelithiasis
  • Diverticulosis
  • Left lower quadrant transplant kidney with moderate hydroureteronephrosis and a ureteral stent in place
  • Atrophic right lower quadrant transplant kidney
  • Bilateral native renal atrophy with numerous bilateral renal structures of varying size and attenuation
  • Mild atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm

MSK

  • No acute findings
  • Multilevel degenerative changes of the spine, most advanced at L2-L3

Diagnosis

Ileocolic intussusception

Sample Report

Ileocolic intussusception extending to the hepatic flexure with associated small bowel obstruction. In an adult, this finding raises concern for a neoplastic lead point. Recommend surgical consultation.

Small left lateral ventral abdominal wall and right inguinal hernias without complicating features.

Left lower quadrant transplant kidney with moderate hydroureteronephrosis and a ureteral stent in place.

Cholelithiasis without evidence of acute cholecystitis.

Diverticulosis without evidence of acute diverticulitis.

Multiple structures of varying size and attenuation in both native kidneys, which likely represent cysts of varying complexity. Recommend nonemergent renal ultrasound for further evaluation if not previously performed.

Discussion

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