Assessment #3 set #1 case #15

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flat ivc, diffuse bowel mural thickening, hypoenh, c/w shock bowel.
no ev of active GI bleed.

Massive hemoperitoneum

There is a blush of contrast in the right lower abdomen likely in the cecum with disperse of contrast on delayed imaging, consistent with acute arterial hemorrhage. There is a large amount of hemoperitoneum. spanning the entire length of abdominal cavity.

Small left and trace right pleural effusion with associated atelectasis.

severe ascites. no active extrav

Atelectasis, pleural effusion
Hiatal hernia?
Dilated esophagus, fluid filled, aspiration risk
narrowing celiac artery origiin
Thickened, edemetous bowel, colon > small bowel. Concern for ischemic colitis. INfectious and inflammatory too.
Ascities
Anasarca

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Hypoperfusion complex. No active hemorrhage identified.

extensive abdominopelvic ascites
extensive edema throughout the small bowel and colon
hyperattenuating adrenals
hypoperfusion complex

shock bowel and shock complex. Large volume abdominal fluid

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Large volume intraperitoneal fluid. Region of hyperattenuation along the right hemiabdomen that disperses on delayed imaging, concerning for active hemorrhage. Regions of hyperattenuaiton and hypoattenuation of the bowel concerning for bowel ischemia and developing shock bowel.
Lung base opacification and left greater than right pleural effusions.

Diffusely edematous appearance of the large and small bowel with submucosal edema and mural thickening and enhancement. No evidence of perforation. No pneumatosis or portal venous gas. The IVC is slit-like and collapsed, raising concern for hypovolemia with resultant ischemic colitis.

Large volume simple appearing abdominopelvic ascites, as well as interloop fluid and diffuse mesenteric edema.

Patulous fluid-filled esophagus, increasing patient’s risk of aspiration.

Small left and trace right pleural effusions with overlying compressive atelectasis.

Likely small volume sludge in the gallbladder. No evidence of acute cholecystitis.

Gastric decompression tube terminates in gastric body.

Foley balloon is inflated in the prostatic urethra rather than the bladder. Recommend repositioning.

Diffuse bowel ischemia with areas of shock bowel.

shock complex. no active hemorrhage identified.
diffuse wall thickening.
marked ascites.
pleural effusion with atelectasis.

Not sure what I’d say here. I’d likely suggest hypoperfusion complex. I don’t see active GI hemorrhage or perforated viscus.

Shock bowel with decreased bowel enhancement in multiple loops of bowel. Cirrhosis and large volume ascites

Mild Cardiomegaly.
Bilateral small pleural effusions with prominent passive atelectasis of the left lower lobe.
Spleen is enlarged measuring ___cm.
Diffuse hypoenhancing bowel.
A filling defect present at the portal confluence and mesenteric veins.
Diffuse edematous bowel wall with hypoenhancement.
Findings suggestive of venoocclusive bowel ischemia.
Large volume simple ascites. No layering of products.
No findings of an acute gastrointestinal hemorrhage.

Large volume hemoperitoneum with active extravasation, which appears to emerge from a branch of the superior mesenteric artery.
Diffuse edematous and hypoenhancing bowel wall is consistent with shock bowel.
Small left and trace right pleural effusions with adjacent atelectasis.
Multiple prominent inguinal lymph nodes are likely reactive.

diffuse bowel edema and hypoenhancememt concerning for bowel ischemia
large volume abdominopelvic ascites

Findings/impression:
Hyperdensity within the bowel in the right lower quadrant on the delayed phase may represent active GI bleed.
Reactive changes of the bowel are present with wall thickening and hyperenhancement. This may represent shock bowel with the given clinical history.
Large volume fluid is present within the abdomen. Recommend correlation with Hounsfield units.
Fluid is present within the distal esophagus, which places the patient risk of aspiration.
Atelectasis is present in the lower lobes. Small left pleural effusion.
Remote granulomatous disease.
No vascular filling defects are visualized.
No perforation of the stomach or bowel is visualized. No free air is visualized.

Shock bowel without perf or portal venous gas.
anasarca.
ascites.
pleural effusion.
atelectasis.

Diffuse wall thickening of the colon likely represents colitis possibly from IBD.

Large volume ascites.

Small left pleural effusion with adjacent atelectasis.

Anasarca.

body wall edema
focal sclerosis right iliac likely bone island
slit like IVC
patent vasculature
pleural fluid with bibasilar atelectaiss/ aspiraciotn
diffuse hypoattenuation of large and small bowel with assicated mural thickening/edema consistent with diffuse hypoperfusion/shock bowel resulting in ischemia.
interloop fluid and ascites. no pneumatosis, pneumoperitoneium , or portal venous gas
contrast extrav in arm

Diffuse intrabadominal visceral hypoattenuation c/w ischemia.
L volume ascites
L effusion. BL atelectasis.
hiatal hernia

Findings consistent with CT hypoperfusion complex with a collapsed IVC, hyperenhancing adrenal glands, and diffuse bowel wall thickening with hyperenhancement of the bowel mucosa indicative of shock bowel. Findings likely relate to hypovolemic shock in the setting of GI bleed.

Large volume of abdominopelvic ascites.

Small left and trace right pleural effusions with adjacent basilar pulonary opacities, repreesenting atelectasis, aspiration, or pneumonia.

Hypoperfusion complex with large volume abdomenal/pelvic fluid/blood products.

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Heterogenous enhancement of bowel with large volume hemoperitoneum with contrast extravasation. Findings favored to represent ischemic bowel with hemorrhagic sequela.

No evidence of active GI bleed.
Findings concerning for hypoperfusion complex given mucusoal hyperenhancement throughout the bowels, flattened IVC, and hyperenhancing adrenals.
Sequalae of volume overload given abdominopelvic ascites, anasarca, and small b/l pleural effusions w/ adjacent atelectasis.

Multifocal pneumonia.
Cirrhotic appearing liver. Portosystemic varices.
Adrenal glands are hyperenhancing.
Enteric tube within the stomach.
Hydropic gallbladder with mural edema likely reactive changes.
Diffuse wall thickening and hypoenhancement of the small bowel. No obstruction.
Large volume ascites and mesenteric edema. No free air.
Diffuse colonic wall hypoenhancement and wall thickening.
Flattened IVC suggestive of a hypovolemic state.

Findings are overall concerning for acute mesenteric ischemia/shock bowel.

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