تعليم الأشعة المقطعية_Ct Scan

• Dilated fluid filled small bowel loops as follows: • Significant dilatation of dudodenum reaching 7.7 cm. • Dilated proximal jejunal loops reaching 5cm. • Average caliber of the rest of the jejunal loops. • Dilated segment of proximal ileal loops reaching 6.2 cm. • The rest of the ileal loops and large bowel are of average caliber. • There is mild swirling of the bowel loops most evident at the duodenojejunal junction. • Average size liver showing homogenous parenchymal atten uation. No focal lesion or dilated biliary radicles. • Patent homogenously enhanced portal vein and its main branches. • Normal CT appearance of both kidneys showing normal site, size and shape with smooth regular outline. No definite masses or back pressure changes. Tiny left lower polar simple cortical cyst measuring 6mm. • Normal C.T appearance of the spleen, adrenal glands, pancreas and IVC. • Diffuse atherosclerotic changes of the abdominal aorta with multiple soft plaques. • The urinary bladder shows no evidence of gross masses or diverticulae or stones. • Normal appearance of the pelvic organs with no collections. • Multiple subcentimetric para-aortic and mesenteric LNs. • No significant ascites. OPINION: • Dilated duodenal, proximal jejunal and segmental ileal loops as above detailed. No definite transition point or soft tissue masses regarding this study • Long standing condition and history of psychiatric medications give the possibility of functional/drug induced obstruction. Also exclude electrolyte imbalance as hypokalemia. • Swirling points especially at the duodenojejunal junction is possibly due to significant bowel dilatation and mobility, yet other causes such as internal hernia are to be considered for clinical correlation.

• Dilated duodenal, proximal jejunal and segmental ileal loops as above detailed. No definite transition point or soft tissue masses regarding this study • Long standing condition and history of psychiatric medications give the possibility of functional/drug induced obstruction. Also exclude electrolyte imbalance as hypokalemia. • Swirling points especially at the duodenojejunal junction is possibly due to significant bowel dilatation and mobility, yet other causes such as internal hernia are to be considered for clinical correlation.

 Age related involutional brain changes in the form of dilated ventricles and widened sulci.  Mild bilateral periventricular hypodensity of deep white matter ischemia .  Age related involutional brain changes with mild deep white matter ischemia.

 Changes related to open heart surgery with mitral valve metallic prothesis and median sternotomy.  Sizable intra-peritoneal collection is seen along anterior subphrenic space scalloping antero-superior hepatic surfaces as well as showing small gases foci measures about 12.6x6.7x10 cm.  Mild perisplenic fluid collection.  Average hepatic size, showing homogeneous hypodense parenchymal pattern, denoting fatty infiltration. No evidence of focal lesions or biliary radicle dilatation.  Both kidneys are of normal site and size showing good excretory function. Left renal simple cortical cysts are noted, the largest about 2.6x2 cm.  Normal CT appearance of the spleen, pancreas, supra-renal glands, aorta, I.V.C and urinary bladder.  Moderate prostatic enlargement is noted.  Moderate circumferential UB wall thickening with regular contour  Aortic atheromatous plaques with attenuated lumen.  No evidence of enlarged retro-crural, para-aortic, pelvic or inguinal lymph nodes.  No ascites.  Large left inguinal bowel loops and omentum containing hernia  Right small fatty containing inguinal hernia CONCLUSION:  Post open heart surgery changes  Large subphrenic heterogenous fluid collection likely infected collection/ abscesses.  Senile prostatic enlargement with chronic cystitis.  Large left and smaller right inguinal hernia.

 Changes related to open heart surgery with mitral valve metallic prothesis and median sternotomy.  Sizable intra-peritoneal collection is seen along anterior subphrenic space scalloping antero-superior hepatic surfaces as well as showing small gases foci measures about 12.6x6.7x10 cm.  Mild perisplenic fluid collection.  Average hepatic size, showing homogeneous hypodense parenchymal pattern, denoting fatty infiltration. No evidence of focal lesions or biliary radicle dilatation.  Both kidneys are of normal site and size showing good excretory function. Left renal simple cortical cysts are noted, the largest about 2.6x2 cm.

 Changes related to open heart surgery with mitral valve metallic prothesis and median sternotomy.  Sizable intra-peritoneal collection is seen along anterior subphrenic space scalloping antero-superior hepatic surfaces as well as showing small gases foci measures about 12.6x6.7x10 cm.  Mild perisplenic fluid collection.  Average hepatic size, showing homogeneous hypodense parenchymal pattern, denoting fatty infiltration. No evidence of focal lesions or biliary radicle dilatation.  Both kidneys are of normal site and size showing good excretory function. Left renal simple cortical cysts are noted, the largest about 2.6x2 cm.  Normal CT appearance of the spleen, pancreas, supra-renal glands, aorta, I.V.C and urinary bladder.  Moderate prostatic enlargement is noted.  Moderate circumferential UB wall thickening with regular contour  Aortic atheromatous plaques with attenuated lumen.  No evidence of enlarged retro-crural, para-aortic, pelvic or inguinal lymph nodes.  No ascites.  Large left inguinal bowel loops and omentum containing hernia  Right small fatty containing inguinal hernia CONCLUSION:  Post open heart surgery changes  Large subphrenic heterogenous fluid collection likely infected collection/ abscesses.  Senile prostatic enlargement with chronic cystitis.  Large left and smaller right inguinal hernia.

 Changes related to open heart surgery with mitral valve metallic prothesis and median sternotomy.  Sizable intra-peritoneal collection is seen along anterior subphrenic space scalloping antero-superior hepatic surfaces as well as showing small gases foci measures about 12.6x6.7x10 cm.  Mild perisplenic fluid collection.  Average hepatic size, showing homogeneous hypodense parenchymal pattern, denoting fatty infiltration. No evidence of focal lesions or biliary radicle dilatation.  Both kidneys are of normal site and size showing good excretory function. Left renal simple cortical cysts are noted, the largest about 2.6x2 cm.

• Mild left pleural effusion. • An oval shaped soft tissue density is seen in the posterior basal segment of the left lower lung lobe, adjacent to the pleura associated with volume loss and curvilinear opacities seen extending from the mass into the ipsilateral hilum (comet tail sign). • Clear right lung field. • No evidence of pneumo-mediastinum or pneumothorax. • Patent tracheo-bronchial tree with no abnormal dilatation. • No hilar or mediastinal masses or lymph node enlargement. • No right pleural or pericardial collection. • Normal plain CT appearance of the heart and great vessels. • The upper cuts of the abdomen taken reveal hepatomegaly. OPINION: - Mild left pleural effusion with underlying round atelectasis rather than consolidation.