Male 63 years old Reason: 63M w/metastatic bladder CA and abdominal pain, ?SBO; MRE to delineate planes between pelvic masses and bowel History: abdominal pain ABDOMEN:LIVER, BILIARY TRACT: Liver is normal is in morphology. No definite solid hepatic lesion. Subcentimeter hypodense focus near the middle hepatic vein is unchanged from prior CT.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis in either kidney. There is a right renal cyst.RETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal lymphadenopathy. There is a duplicated IVC with bilateral stents.Left femoral vein deep venous thrombosis is better evaluated on the CT scan.BOWEL, MESENTERY: Upper abdominal small bowel is dilated which may be due to enterography technique. There is a focal obstruction adjacent to the left lower rectus muscle due to a soft tissue mass measuring 3.1 x 2.4 cm involving the proximal ileum. There is a second area of narrowing involving the rectosigmoid junction in the pelvis with direct extension of tumor that extends to the left pelvic sidewall. The mass in this region measures 4.2 x 3.6 cm.BONES, SOFT TISSUES: Right body wall metastatic deposits. Soft tissue mass adjacent to the right ileal conduit most suspicious for disease near the ostomy site.OTHER: Trace upper abdominal ascites.
1.Small bowel obstruction in the proximal ileum in the lower quadrant due to an obstructing mass. Obstruction is near complete.2.Second site of bowel obstruction which is incomplete involving the proximal rectum due to extension of left pelvic sidewall mass.3.Right body wall metastases and metastases adjacent to the right lower abdominal ileal conduit.4.Confluent retroperitoneal lymphadenopathy.