Recurrent bowel obstruction versus severe constipation. Evaluate for stricture. ABDOMEN:LIVER, BILIARY TRACT: Right hepatic dome simple appearing cyst. No suspicious liver lesion. The liver is normal in morphology, size, signal intensity and enhancement. No suspicious liver lesion or biliary duct dilatation. Partially contracted gallbladder.SPLEEN: The spleen is normal in size and signal intensity without a focal lesion.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The small bowel is adequately distended with oral contrast. The small bowel fold pattern is maintained.There is a long segment of small bowel in the left hemiabdomen which is persistently dilated up to 4.3 cm. There is no associated bowel wall thickening, restricted diffusion, T2 weighted signal abnormality or postcontrast abnormal enhancement. No obstructing mass or flow limiting stricture is evident. No perienteric inflammatory changes, fibrofatty proliferation or reactive lymphadenopathy.The terminal ileum is well seen and is unremarkable.The colon is normal caliber without evidence of active inflammation or flow limiting stricture.No free fluid or loculated fluid collection. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Nodular signal abnormality in the right lung base without corresponding abnormality on recent chest CT.
1. Persistently moderately dilated single long segment of small bowel in the left hemiabdomen without a discrete obstructing mass or stricture evident. There is no significant upstream dilatation. This may be residua of the recent resolved bowel obstruction. No specific findings to account for the patient's recent bowel obstruction. No evidence of active inflammation, flow limiting stricture or discrete mass. Adhesive disease remains on the differential.2. Right lung base nodule, not seen on recent chest CT. Also likely infectious/inflammatory, a repeat diagnostic chest CT in 3-6 months is recommended to confirm resolution. (Findings were paged to the covering service for pager 2750 at 1703 03/31/2016).