31-year-old female with right lower quadrant pain. Evaluate for TOA and appendicitis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: The spleen is enlarged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate nonobstructing right renal calculi are evident.RETROPERITONEUM, LYMPH NODES: Numerous small mesenteric lymph nodes are evident as well as a few prominent retroperitoneal nodes.BOWEL, MESENTERY: Trace peritoneal fluid. The appendix is normal. The omentum and peritoneum are infiltrated and the small bowel, particularly in the left lower quadrant, appears matted. Along with the presence of numerous mesenteric and retroperitoneal lymph nodes as described above, these findings most likely represent a diffuse inflammatory process such as gastroenteritis or mesenteric adenitis. Neoplastic disease is considered less likely.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Bilateral adnexal cystic lesions are inadequately evaluated on CT. If further imaging evaluation is clinically warranted, gynecologic ultrasound or MRI may be considered.BLADDER: No significant abnormality notedLYMPH NODES: Multiple prominent iliac, obturator, and inguinal lymph nodes are seen. See discussion above.BOWEL, MESENTERY: See above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
Omental and mesenteric infiltration along with matted bowel and numerous mesenteric, retroperitoneal and pelvic lymph nodes suggests a diffuse inflammatory process such as gastroenteritis or mesenteric adenitis. Neoplastic disease is considered less likely. Cystic adnexal lesions may be further evaluated on ultrasound or MRI if clinically indicated.