Assessment #1 case-set #3 case #7

Dilated small bowel with paucity of gas in the rectum, concerning for SBO.

ileus

cecal volvulus

Dilation of ascending and transverae colon concern for large bowel obstructin.

colonic obs

Distended colon with abnormal orientation, concerning for cecal volvulus. No pneumoperitoneum. CCY clips. No acute osseous findings.

marked colon dilation, toxic megacolon

Gaseous dilation of ascending and transverse colon with decompression of distal bowel. Differential includes colitis, ileus or large bowel obstruction. No supine free air or pneumatosis.

Gaseous dilatation of the large bowel, most prominent in the transverse colon with a maximal diameter of xx. Decreased haustration with relative lead-pipe appearance, and scattered foci of hyperdensity along the course of the bowel which may represent pseudomembranes. This constellation of findings is concerning for toxic megacolon. Rec surgery consultation.

severe gaseous dilation of small bowel loop with rigglers sign. Concern for pneumatosis, concern for volvulus or a closed loop obstruction.

Gaseous dilation of the transverse colon measuring up to x cm, distal rectal gas is visualized. Findings may represent ileus, colonic pseudoobstruction, or colitis.
Bilateral inguinal hernias.

Dilation measure up to x, can be seen in ileus vs obstruction.

asym dilated loops of small bowel suggestive of SBO.

sig LB dilation measuring x primarily in transverse colon with pacuuity of gas in descending colon but with gas still prsenet in rectum. this may rep LBO. These findings can also be seen ISO of pancreatitis. rec correlation with serum lipase.

Severe dilation predominately of the transverse colon and to a lesser extent of the ascending colon with thumbprinting, concerning for toxic megacolon. Recommend CT for further evaluation.
No pneumatosis or portal venous gas.

Markedly dilated loops of central bowel loops, most predominately involving the transverse colon. Findings concerning for obstruction.

Dilated gas filled transverse colon and small amount of distal colorectal bowel gas. Findings concerning for partial large bowel obstruction or pseudoobstruction.

Marked distension of the large colon up to xx cm concerning for obstruction. Recommend CT a/p for evaluation. No supine signs of pneumoperitoneum.

Large bowel dilation concerning for obstruction or ileus

dilation of the colon concerning for toxic megacolon.

Severe dilation of the transverse colon measuring up to x cm in width. Gas is noted distally at the level of the rectum. These findings may suggest LBO or ileus in the correct clinical setting.

dilation of large bowel transverse colon, gas seen distally. could be developing lbo.
Toxic megacolon and pseudomembranous colitis on ddx.

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Gaseous distention of loops of large bowel up to x cm concerning for bowel obstruction.

Dilated large bowel measuring up to x cm, concerning for cecal volvulus causing a large bowel obstruction. Moderate stool burden.

Dilation of the ascending and transverse colon, measuring up to X cm, concerning for large bowel obstruction. Question pneumatosis of bowel over RLQ.

Volvulus

Large bowel obstruction

Gaseous distention of the large bowel concerning for obstruction or colitis. Toxic megacolon cannot be excluded. Consider further evalaution with CT abdomen/pelvis. Recommend attention of follow-up.

FINDINGS:

Surgical clips in the RUQ. Small density in the RLQ, probably a pill capsule.

Markedly dilated loop of large bowel with a few normal caliber loops of small bowel overlying the pelvis. No supine evidence of pneumoperitoneum, portal venous gas, or pneumatosis. The bones are unremarkable.

IMPRESSION:

Markedly dilated large bowel with suspicion of obstruction. Recommend urgent surgical consultation.

Massively dilated large bowel measuring up to x cm with possible appendicolith in the RLQ. These findings are nonspecific and may reflect acute appendicitis versus contents in the enteric stream. Consider CT AP for further evaluation.

Dilated loops of large bowel concerning for large bowel obstruction.

Extensive dilation of the transverse colon concerning for possible LBO or toxic megacolon. Small amount of pneumatosis near the splenic flexure. Consider CT for further evaluation.

There is significant dilation of transverse colon. The sigmoid colon is gaseous and nondilated. This may represent acute onset of volvulus of the transverse colon versus early large bowel obstruction in the appropriate clinical setting.

dilated transverse colon, concerning for ileus.

assymetric dilatation of transverse colon with relative decompression of distal large bowel, which could represent large bowel obstruction. Toxic megacolon could have a similar appearance in the correct clinical setting.

large bowel obstruction iwht diliaton of sigmoid loop – sigmoid volvulus

Gaseous dilatation of the large bowel, concerning for toxic megacolon or other colitis. Recommend CT for further evaluation.
Radiodensities projecting over the right lover quadrant, nonspecific but could represent appendicolith.

Massive dilation of the large bowel suggestive of large bowel obstruction. Pneumatosis.

Dilated transverse colon – large bowel obstruction

Lbo
Appendicito lith

Severely dilated large bowel measuring up to X mm in the largest diameter concerning for large bowel obstruction. Additionally, there are areas of “tram track” appearance within the bowel wall which may represent pneumatosis/ischemic bowel.

Markedly dilated large bowel concerning for large bowel obstruction. Consider CT abdomen.

Massively dilated transverse colon measuring up to X cm. There is a curvilnear lucency projecting over the right hemiabdomen which appears to be continuous with the wall of the colon indicating pneumatosis. Constellation of findings could represent Toxic megacolon in the appropriate clinical setting or could indicate large bowel obstruction. Recommend obtaining CT for further evaluation.

Large bowel dilitation, consider large bowel obstruction

Findings concerning for large bowel obstruction with pneumatosis. Recommend CT with contrast and emergent surgery consult.

Large bowel obstruction

lbo, poss tp in the left up quad.

Significant dilation of the colon concerning toxic megacolon in the setting of fever.

f

Nonspecific gaseous dilation of transverse colon. Nonobstructive bowel gas pattern. Given fever and abdominal pain, findings could be seen with toxic megacolon. Questionable irregular triangular lucency over the hepatic flexure, which may reflect pneumoperitoneum. Recommend CT for further evaluation.

large bowel obstruction

Dilation of the transverse colon, concerning for large bowel obstruction. CT could further evaluate as clinically indicated.

Markedly dilated large bowel, particularly the transverse colon which measures up to X cm. These findings can be seen in the setting of pseudoobstruction, ileus, or toxic megacolon in the appropriate clinical setting.

Large bowel obstruction with significant distension of colon.

LBO

Gaseous dilatation of the large bowel, primarily the transverse colon, concerning for mechanical bowel obstruction vs. colonic pseudoobstruction. Recommend surgical consultation and CT abdomen/pelvis for further evaluation.

cc

Sig dilation of transverse colon with triangular luncencies in RUQ that do not appear to follow contours of bowel, concerning for pneumoperitoneum. Linear/curvilinear luncicines about bowel in RLQ may be pneumatosis.

Dilated large intestine/colon measuring up to ___ cm, concerning for toxic megacolon. Linear lucencies along bowel looks in the right hemiabdomen are concerning for pneumatosis vs peritoneal free gas. recommend CT abdomen for further evaluation.
Gas within the rectum suggests non-obstructive bowel gas pattern.
Visualized lung bases are unremarkable. No acute osseous findings.

Dilated loop of large bowel with non gaseous rectum suspicious for large bowel obstruction. Recommend CT of the abdomen for further evaluation.

Gaseous dilation of the colon with air in the rectum which may represent possible LBO, LB pseudoobstruction, or ileus.
Generalized luceny throughout the abdomen including a lucent liver sign which may represent pneumoperiotneum. Consider decubitus radograpohs or ct ABDOMEN FOR FURTHER EVALUATION.

Toxic megacolon. Triangular air locule near the hepatic flexure concerning for pneumoperitonium. Recommend CT A/P.

Large bowel obstruction as evidenced by dilated loop of predominantly transverse colon. Small triangular lucency concerning for pneumoperitoneum at the falciform ligament.

Lucent liver. Evidence of pneumotosis with riglers and mottled RLQ. Dilated large bowel may be concerning for obstruction

significant gaseous distension of the large bowel, concerning for large bowel obstruction. increased lucency over the liver and spleen could represent pneumoperitoneum, though evaluation is limited given supine positioning. cholecystectomy clips in RUQ

Marked dilation of the transverse colon with haustral thickening and mucosal irregulartities with relative decompression of the descending colon. Differential considerations include toxic megacolon, large bowel obstruction, and pseudoobstruction.

Lucent liver concerning for pneumoperitoneum. Rec gen surg consult and CT A/P.

Marked enlargement of the ascending and especially transverse colon with wall thickening and possible pneumatosis (versus pseudopneumatosis) within the proximal ascending colon and possible Riggler’s sign concerning for pneumoperitoneum; however, exam is limited in the setting of supine technique.

Overall, findings are concerning for toxic megacolon and possible partial large bowel obstruction, although there is some gas visualized within the rectum. Recommend CT abdomen for further assessment and C. Diff testing as clinically warranted.

Ovoid radiopacities project within the ascending colon, possibly ingested content such as pills.

Cholecystectomy clips.

Colonic dilatation and mural thickening of the transverse colon concerning for toxic megacolon. Pneumoperitoneum.
B/l inguinal hernias.

Colonic obstruction vs ileus with possible perforation

Massive dilation of the large bowel measuring xx cm in the transverse colon concerning for large bowel obstruction vs pseudoobstruction. Gas projects over the rectum. Toxic megacolon is a differential consideration given extent of distention and clinical fever. Possible triangular air above the right 11th rib which may represent air in morrisons pouch (Doge cap sign). Attention on follow up imaging. Calcification in the right lower quadrant which is favored to represent calcs in the fecal stream vs less likely appendicoliths.

DIlated gas filled looped of large bowel. No definitive volvulus seen. No pneumatosis. Possible free intraperitoneal air but limited on supine film. Recommend repeat upright or LLD.

Large bowel obstruction w/ pneumoperitoneum

Notable gaseous dilation of large bowel loops throughout the abdomen with gas seen within the rectum. There is a linear lucency along the hepatic flexure, concerning for pneumoperitoneum.

Consider CT for further eval if there is acute clinical concern.

Dilation of the transverse colon with pneumatosis and increased lucency over the liver concerning for free air.