52-year-old male with chronic renal insufficiency presents with two weeks of abdominal pain, vomiting, diarrhea. Lack of intravenous contrast is noted to lower the sensitivity for detection of solid organ pathology.ABDOMEN:LUNG BASES: Bi-basilar scarring or atelectasis. Several prominent paraesophageal and paradiaphrgmatic prominent lymph nodes are appreciated, the largest measures 1.5 in length and is unchanged.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Marked fat replaced atrophy of the pancreas is notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild diffuse perinephric fat stranding is seen bilaterally, likely product of chronic renal medical disease. No hydronephrosis. RETROPERITONEUM, LYMPH NODES: A few scattered subcentimeter mesenteric lymph nodes are also identified.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: A single bladder diverticulum from the posterior-superior aspect of the bladder wall near the right UV junction, may represent a Hutch diverticulum.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is abnormal fat stranding seen involving the proximal portion of the transverse colon in the region of the hepatic flexure. Findings may be seen with an inflammatory, infectious, or possibly ischemic etiologies. There is diffuse chronic gastric wall thickening which may be due to gastritis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
Persistent abnormal fat stranding in region of hepatic flexure of transverse colon is identified, findings suggestive of an infectious process given acute abdominal pain, differential includes inflammatory or ischemic etiologies.No significant interval change since 9/9/08.