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Case #20

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Demographics: 57 years old, Male
Indication: Lower abdominal pain, recent renal transplant

Findings

  • Gaseous distension of multiple loops of small bowel with air-fluid levels on upright imaging. Gas is seen distally in the large bowel
  • Curvilinear lucencies outlining the urinary bladder
  • Stent overlies the left aspect of the anatomic pelvis, likely associated with the transplant kidney
  • Midline abdominal surgical staples
  • Right abdominal chain sutures
  • Calcified gallstones in the right upper quadrant
  • Platelike right basilar atelectasis
  • Left subclavian approach central venous catheter with tip overlying the SVC

Diagnosis

Emphysematous cystitis

Sample Report

Curvilinear lucencies outlining the urinary bladder, which raises concern for emphysematous cystitis. Recommend correlation with urinalysis and CT for further evaluation.

Gaseous distension of multiple loops of small bowel with air-fluid levels on upright imaging which may relate to postsurgical ileus or partial small bowel obstruction. Recommend attention on serial abdominal exams. This could also be further evaluated with CT.

Discussion

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