42 year old female. Status post vaginal hysterectomy. Now has bandemia and abdominal pain. Right CVA TTP, fever and rigors. DM. Evaluate for perinephric abscess. ABDOMEN:LUNG BASES: Mild bibasilar dependent atelectasis. LIVER, BILIARY TRACT: Hepatomegaly. The liver measures 22 cm overall. Periportal edema seen previously has resolved. There are hepatic hypodensities which are subcentimeter in size and unchanged since prior examination, probably benign. SPLEEN: No significant abnormality noted. Splenules at the hilum and lower pole. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The previous examination found left hydronephrosis and hydroureter which has resolved. No specific renal abnormality was identified.RETROPERITONEUM, LYMPH NODES: Multiple borderline enlarged pericaval and paraaortic lymph nodes inferior to the kidneys. BOWEL, MESENTERY: No significant abnormality noted. Normal appendix in the right lower quadrant. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No abscess or ascites. The celiac and superior mesenteric arteries share a common origin, a normal anatomic variant. This is seen best on midline sagittal view.Umbilical Richter's hernia contains nonobstructed bowel.PELVIS:UTERUS, ADNEXA: Status post hysterectomy. Large central pelvic multiloculated cystic mass with wall enhancement was seen on the prior exam and is much smaller. The mass measures 8.7 x 12 cm. No gas bubbles. May be further evaluated with transvaginal ultrasound and/or MRI, if indicated. BLADDER: No significant abnormality notedLYMPH NODES: Mildly enlarged left iliac lymph nodes.BOWEL, MESENTERY: No significant abnormality notedqBONES, SOFT TISSUES: Intramuscular cystic lesion at right rectus femoris muscle image 101 of series 3) is stable since the prior exam and does not have characteristics of an abscess. OTHER: No significant abnormality noted
The multiloculated central pelvic mass seen on the prior exam of 2/21/2010 is much smaller. Interval resolution of left hydroureter and hydronephrosis. Pelvic ultrasound exam may be helpful for further evaluation.  