Female 50 years old Reason: Assess small bowel wall thickening in patient with duodenal switch History: RUQ, epigastric pain ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions. Hepatic and portal veins are patent. Gallbladder is distended containing sludge near the fundus. No biliary ductal dilatation.SPLEEN: Spleen is normal in sizePANCREAS: Pancreas is normal in morphology. No surrounding inflammatory changes. Pancreatic duct is normal in caliber.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cyst located in the lower pole of the left kidney. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes from a duodenal switch procedure. The limb of bowel connected to the distal stomach has a thickened wall with submucosal edema. The abnormal loop of bowel extends to the level of the distal anastomosis in the right mid abdomen. About the proximal anastomosis, there is significant soft tissue thickening and hyperenhancement. No bowel obstruction is evident.There is a small amount of mesenteric edema surrounding the inflamed loop.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Left ovary contains multiple cysts.There are small cervical nabothian cysts.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes in the midline abdomen.OTHER: No pelvic ascites
1.Thickening of the loop of bowel connecting the stomach to the level of the distal anastomosis. Imaging features are most suggestive of an enteritis.2.No bowel obstruction, or fluid collections.3.Gallbladder sludge and mild gallbladder distention.