Female; 44 years old. Reason: bright red blood per rectum. History: abdominal pain, LLL quadrant ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Few subcentimeter omental, mesenteric, and cardiophrenic lymph nodes are likely benign, however could also represent early metastatic disease in the setting of ovarian carcinoma.BOWEL, MESENTERY: Narrow-mouthed low midline ventral hernia containing mesenteric fat, a small bowel loop, and small amount of free fluid (series 3 image 111). No wall thickening in the herniated loop or evidence of obstruction. There is a mild amount of surrounding stranding in the pannus, suggestive of mild inflammation. The hernia sac measures approximately 13 x 8.5 cm with a 3-cm orifice.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Uterus is absent. Enlarged left adnexa/ovary (series 3 image 120) measures 4.8 x 4.3 cm; ovarian mass cannot be excluded and correlation with gynecologic ultrasound and/or MRI is advised. Cystic lesion in the right ovary (series 3.1) measures 4.1 x 3.5 cm.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
1. Ventral hernia containing small bowel loop and small free fluid with mild inflammatory changes of the surrounding  pannus. No evidence of bowel obstruction or bowel inflammation. 2. Enlarged, solid appearing left ovary and a 4 cm cyst in the right ovary. Correlation with pelvic ultrasound or MR is recommended to exclude a mass.Critical findings discussed and acknowledged by Dr. Patel via telephone at the time of dictation. 