82-year-old male with history of colon cancer, status post resection. Presents with abdominal distention and emesis This examination is limited by the absence of intravenous contrast. ABDOMEN: Within the limits of a non-IV contrast enhanced examination of following observations are made. LUNG BASES: No significant abnormality noted LIVER, BILIARY TRACT: No significant abnormality noted SPLEEN: No significant abnormality noted PANCREAS: No significant abnormality noted ADRENAL GLANDS: Low-attenuation right adrenal gland lesion with characteristics typical of benign adenoma seen unchanged dating back to MRI exam of 3/3/2004. KIDNEYS, URETERS: Small kidneys bilaterally with bilateral urinary tract calculi seen. The total burden of calcifications appears relatively unchanged although the location of these calcifications has changed from 2007. No hydronephrosis. Simple cyst seen bilaterally unchanged. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted. BOWEL, MESENTERY: Marked dilatation of colon with redundant colon isvirtually unchanged since CT 1/3/207 and similar to computed radiographs dating back to 2004. Colon is seen with distention and fluid and air through the entire length through to the rectum although collapse of the sigmoid is seen at one location but without surrounding mass. While CT cannot exclude a colonic neoplasm, there is no mass effect around this collapsed colon and this presumably is physiologic. Small bowel is dilated distally while proximally it is of normal caliber. There is no transition point throughout the entire colon to suggest an element of obstruction and this pattern and the chronicity suggests colonic pseudoobstruction. BONES, SOFT TISSUES: No significant abnormality noted OTHER: No significant abnormality noted PELVIS: PROSTATE, SEMINAL VESICLES: No significant abnormality noted BLADDER: No significant abnormality noted LYMPH NODES: No significant abnormality noted BOWEL, MESENTERY: See above discussion in the abdomen. BONES, SOFT TISSUES: No significant abnormality noted OTHER: No significant abnormality noted
1. Marked diffuse dilatation of the colon to maximum diameter 12 cm, without evidence of mass lesion or transition point -- chronic dating back to 2004. Findings are most consistent with colonic pseudoobstruction.2 Right adrenal adenoma is unchanged 3. Bilateral renal calculi with no evidence of urinary obstruction. 