Wk 5, Case 44 - Review

TECHNIQUE:
CT of the abdomen and pelvis WITH intravenous contrast.

COMPARISON: None.

FINDINGS:

LOWER THORAX: Normal.

HEPATOBILIARY: No focal hepatic lesions. No biliary ductal
dilatation.


SPLEEN: No splenomegaly.


PANCREAS: No focal masses or ductal dilatation.

ADRENALS: No adrenal nodules.


KIDNEYS/URETERS: No hydronephrosis, stones, or solid mass lesions.

PELVIC ORGANS/BLADDER: Unremarkable.

PERITONEUM / RETROPERITONEUM: There is a large amount of perihepatic, perisplenic, and to a lesser degree pelvic free fluid.


LYMPH NODES: No lymphadenopathy.


VESSELS: Unremarkable.

GI TRACT: There are multiple loops of small bowel in the left lower quadrant which do not have oral contrast within them. The loops are fluid-filled and dilated. There is significant amount of fluid surrounding the small bowel loop with some stranding at the small bowel loops. There is suggestion of mesenteric crowding in this location. Distal to the loops of small bowel, the bowel is decompressed. Proximal to these loops, the small bowel loops are distended. The colon is decompressed.

BONES AND SOFT TISSUES: Unremarkable.

IMPRESSION:
1. Findings consistent with incarcerated internal hernia/closed loop bowel obstruction.
2. Large amount of free fluid in the peritoneal cavity.