19 year old male with a history of small bowel polyps complicated by intussusception status post small bowel resection. Somewhat suboptimal distention of the proximal small bowel limits evaluation for small polyps.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is gastroduodenal dilation to the level of the 3rd portion of the duodenum. Oral contrast is noted to pass beyond this point into the distal small bowel. No definite polyps are identified in the imaged portions of the small bowel or colon. PELVIS: Somewhat suboptimal distention of the proximal small bowel limits evaluation for small polyps.PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Scattered mesenteric lymph nodes.BOWEL, MESENTERY: There is gastroduodenal dilation to the level of the 3rd portion of the duodenum. No definite polyps are identified in the imaged portions of the small bowel or colon. BONES, SOFT TISSUES: Note is made of multiple foci of metal susceptibility artifact in the soft tissues along the midline of the abdomen and pelvis, consistent with postoperative changes/clips.
1.Postoperative changes without definitive evidence of small bowel polyps, as clinically questioned. Further evaluation with a CT enterography should be considered to further evaluate for small bowel polyps, if there is continued clinical concern. 2.Gastroduodenal dilation to the level of the 3rd portion of the duodenum is nonspecific but has been described in patients with SMA syndrome. Alternatively, given the patient's surgical history, this could also represent an anastomotic stricture or adhesive disease and clinical correlation is indicated. Further evaluation with an upper GI fluoroscopic examination may be considered if clinically indicated. 