Demographics:
84 years old, Female
Indication:
Vomiting, melena
Findings
Lower chest
- Mild dependent atelectasis
- Mild four chamber enlargement of the heart
- Coronary artery calcification
- Moderate-sized hiatal hernia with layering fluid
Abdomen/Pelvis
- Thrombus in the mid and distal SMA extending into proximal jejunal branches
- Mild luminal distension and wall hypoenhancement of an approximately 20 cm segment of jejunum in the left mid abdomen
- Liver is mildly enlarged with diffuse low attenuation of the hepatic parenchyma
- Scattered hepatic cysts and additional subcentimeter hypoattenuating lesions which are too small to characterize
- Subcentimeter hypoattenuating lesions in both kidneys are too small to characterize
- Appendectomy
- Colonic diverticulosis
- Uterine fibroid
- Trace free fluid layering in the anatomic pelvis
MSK
- No acute findings
- Degenerative changes of the spine and pubic symphysis
Diagnosis
Acute mesenteric ischemia due to arterial occlusion
Sample Report
Thrombus in the mid and distal SMA extending into proximal jejunal branches which may represent in situ thrombus versus thromboembolism.
Mild distension and wall hypoenhancement of an approximately 20 cm segment of jejunum in the left mid abdomen is concerning for developing bowel ischemia.
No pneumatosis, portal venous gas, or pneumoperitoneum.
Moderate-sized hiatal hernia with layering fluid, which places the patient at risk for aspiration.
Hepatomegaly with hepatic steatosis.
Discussion
References