Abdomen quiz


Question 1

1. What is the diagnosis?

Question 2

2. What is the diagnosis?

Question 3

3. Where is the main abnormality?

Question 4

4. What is the main abnormality?

Question 5

5. Where is the bright object located?

Question 6

6. Where is the bright object located?

Question 7

7. How many abnormalities do you see?

Question 8

8. Is this a normal scan?

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1. What is the diagnosis?
There is a moderately sized simple renal cortical cyst in the left kidney. It is very well circumscribed with sharp defined edges and is of fluid density.

2. What is the diagnosis?
This slice is set in lung window, hence the brightness of the abdominal soft tissues. There are multiple dilated loops of small bowel. This is small bowel ischaemia as intramural air is present, best seen in the loops on the right.

3. Where is the main abnormality?
Liver metastases are present - there are two obvious hypoattenuating areas in the liver, and the rest of the visible liver has a heterogenous (uneven) density. There is also a small amount of ascites surrounding the liver, likely related to the metastatic disease.

4. What is the main abnormality?
This is a massive AAA. It has ruptured as there is a large amount of blood (denser than fluid stomach contents) in the retroperitoneum (next to kidney and aorta). The two lesions in the liver are most likely simple liver cysts, as they are well-circumscribed and of fluid density (similar density to stomach contents, less dense than blood). Liver cysts occur less commonly than renal cysts.

5. Where is the bright object located?
The bright object is located in the small bowel, and is causing obstruction. There is dilatation of the small bowel loop it is in, and collapse of the distal small bowel loops. This is a large gallstone obstructing the small bowel - i.e. gallstone ileus. Did you notice another smaller bright object in the stomach? This is a cross-section through an NG tube.

6. Where is the bright object located?
Likely causes of a bright object in the stomach - certain pills, certain foods (e.g. seeds, bones), cross-section through tubes.

7. How many abnormalities do you see?
There are 3 main abnormalities as follows:
1. Multiple small gallstones in the gallbladder.
2. IVC filter in situ.
3. Distended (urinary) bladder.

8. Is this a normal scan?
This CT scan has been performed without contrast - in this case, it is a KUB scan that was performed to look for renal stones.
Did you find the stone? It is in the left ureter at the level of the pelvic brim. There is associated mild hydroureter and hydronephrosis on this side.


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