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CT ABDOMEN PELVIS W CONTRAST while hospitalized in 2020
Study Result
Narrative
PROCEDURE: CT ABDOMEN PELVIS W CONTRAST
COMPARISON: None.
INDICATIONS: Right upper quadrant and epigastric abdominal pain for 12 days, jaundice.
TECHNIQUE: After obtaining the patients consent, CT images were created with intravenous iodinated contrast.
FINDINGS:
LIVER: No suspicious liver lesion is seen. The portal and hepatic veins are patent. There is minimal periportal edema centrally.
BILIARY: The gallbladder does not appear significantly distended. There is diffuse gallbladder wall thickening measuring up to 8-9 mm in diameter, corresponding to findings on the concomitant ultrasound. No significant pericystic inflammatory changes are detected. Common bile duct measures up to approximately 5 mm in diameter, within normal limits for age.
PANCREAS: No focal pancreatic lesion. No pancreatic duct dilation.
SPLEEN: No suspicious splenic lesion is seen. The spleen is normal in size.
KIDNEYS: No suspicious renal lesion is seen. No hydronephrosis.
ADRENALS: No adrenal gland nodule or thickening.
AORTA/VASCULAR: No aneurysm.
RETROPERITONEUM: No lymphadenopathy.
BOWEL/MESENTERY: No bowel wall thickening or bowel dilation. Visualized portions of the appendix are nondilated and without surrounding inflammatory change.
ABDOMINAL WALL: Tiny fat-containing umbilical hernia.
URINARY BLADDER: No focal wall thickening or calculus.
PELVIC NODES: No lymphadenopathy.
PELVIC ORGANS: Simple appearing cyst/follicle in the right ovary measuring up to 1.8 cm. Mildly lobular uterine fundus, suggestive of uterine fibroids.
BONES: No acute fracture or suspicious osseous lesion.
LUNG BASES: No pleural effusion or consolidation.
OTHER: No intraperitoneal free air, portal venous gas, or pneumatosis detected.
CONCLUSION:
1. Diffuse gallbladder wall thickening, also seen on the concomitant ultrasound, which is nonspecific and can be seen in the setting of acute and chronic cholecystitis as well as low protein states and liver disease. Given the presence of a positive sonographic Murphy's sign on the ultrasound, cholecystitis is suspected. If there is clinical uncertainty, correlation with a HIDA scan (preferably with ejection fraction) could be performed.
2. No dilated bowel loops to suggest bowel obstruction.
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MRI MRCP ABDOMEN WO CONTRAST while hospitalized in 2020
Narrative
PROCEDURE: MRI MRCP ABDOMEN WO CONTRAST
COMPARISON: None.
INDICATIONS: abnormal LFTs and RUQ abd pain
TECHNIQUE: Multiplanar and multiparametric images of the abdomen were obtained without intravenous gadolinium contrast. Magnetic resonance cholangiopancreatography was also performed.
FINDINGS:
LIVER: No focal liver lesion is seen. The liver is normal in size and signal.
BILIARY: As documented on previous CT there is evidence of cholelithiasis with gallbladder wall edema as well as edema extending into the hepatic hilum and portal triads. No dilatation of the intra or extrahepatic biliary ducts is seen in the common bile duct measures approximate 5 mm the pancreatic head. No filling defects are seen in the biliary tree area
PANCREAS: No cystic or solid pancreatic lesion. No pancreatic duct dilation.
SPLEEN: No focal splenic lesion is seen. The spleen is normal in size.
KIDNEYS: No suspicious renal lesion is seen. No hydronephrosis.
ADRENALS: No adrenal gland nodule or thickening.
AORTA/VASCULAR: No aneurysm or dissection.
RETROPERITONEUM: No lymphadenopathy.
BOWEL/MESENTERY: No bowel wall thickening or bowel dilation in the partially imaged bowel.
ABDOMINAL WALL: No hernia.
BONES: No suspicious osseous lesion.
LUNG BASES: No pleural effusion or consolidation.
OTHER: Negative.
CONCLUSION:
1. No evidence for biliary duct dilatation. Common bile duct is 5 mm with no filling defects.
2. Consistent with previous CT findings is contracted gallbladder with cholelithiasis and gallbladder wall edema as well as edema in the hepatic hilum and portal triads. This is suspicious for primary gallbladder inflammation and should be correlated clinically.
3. No evidence for pancreatic duct dilatation.
4. No other significant incidental findings.