Reason: Please evaluate for possible obstruction, h/o of FAP s/p proctocolectomy with IPAA 1996 History: recurrent bowel obstructions with abdominal pain, distension and vomiting and hospitalized twice since January. Usually minor episodes that resolve on own every 4-6 weeks. The scout film showed a nonspecific bowel gas pattern a focally dilated loop of small bowel in the left upper quadrant. Multiple gallstones and a right ureteropelvic junction calculus are noted. Additional small nephrolithiasis suggested in the lower pole of the right kidney.There is long segmental relative narrowing of the proximal aspect of the J-pouch, as seen on the prior MRI from 6/10/2016, and measuring approximately 13.5 cm in length. This area is widely patent with lumen measuring up to 3 cm. Overall there is diffuse dilatation of small bowel. All of these findings are consistent with a normal postoperative appearance, with chronic changes reflective of patient's prior total colectomy with formation of J-pouch.Fluoroscopy Time: 2 minutes 27 secondsDose area product: 3480 uGy*m2Entrance dose: 97 mGy
1. No evidence of bowel obstruction. 2. Long segmental mild relative narrowing of the proximal aspect of the J-pouch, as seen on the prior MRI from 6/10/2016, and measuring approximately 13.5 cm in length. Luminal dilatation much improved compared to earlier MRI and site is widely patent with lumen measuring up to 3 cm. Overall there is diffuse dilatation of small bowel. All of these findings are consistent with a normal postoperative appearance, with chronic changes reflective of patient's prior total colectomy with formation of J-pouch. 