49 year old female. Abdominal pain. Is there a persistent GE junction leak? CHEST:LUNGS AND PLEURA: Bilateral lower lobe consolidation and volume loss. Small bilateral pleural effusions. There is possible abscess or small hematoma in the cysts splenic bed, left sub-diaphragmatic region seen best on coronal image 79.MEDIASTINUM AND HILA: Endotracheal tube is present in the expected position. Low lung volumes.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Marked hepatomegaly. The liver measures 27 cm craniocaudally.SPLEEN: Status post splenectomy.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral atrophic and scarred kidneys without evidence of hydronephrosis. There is a questionable 3-cm mass adjacent to the right lung hilum on coronal image 69 and axial image 106. This may be further evaluated with dedicated renal MRI examination and/or noncontrast CT scan.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The patient is status post a vertical sleeve gastrectomy with innumerable surgical clips under the left hemidiaphragm. A stent is present in the gastric remnant. There are multiple surgical drains in the upper abdomen, one in the gastrohepatic region and another at the left lateral aspect of the gastrectomy site.A percutaneous jejunostomy tube is present in the expected position.No free air. No definite leak at the GE junction, but this may be difficult to detect on an examination without esophageal enteric contrast.BONES, SOFT TISSUES: Open midline abdominal wound in the supraumbilical region. OTHER: IVC filter is in expected position.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: A Foley catheter is present in the decompressed urinary bladder.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: A rectal tube is in expected position.BONES, SOFT TISSUES: There is scoliosis of the thoracolumbar spine. Degenerative changes in the lumbosacral spine and pelvis.OTHER: Anasarca.
Bibasilar lower lobe consolidation. Hepatomegaly. Anasarca. Questionable right renal mass at the hilum. Status post splenectomy with questionable hematoma or subdiaphragmatic fluid collection on the left. Multiple additional findings, as described above. Postop changes after partial gastrectomy.