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RADIOLOGY: GASTROINTESTINAL: GI: Case# 32929: SMALL BOWEL ISCHEMIA SECONDARY TO RENAL CELL CA. 42-year-old white female. 1. Extensive small bowel pneumatosis with mesenteric venous gas which is worse in the proximal small bowel. There is also significant colonic wall edema in the distribution of the inferior mesenteric artery. These findings are consistent with ischemic bowel; infarction is suspected in the proximal small bowel. It is of note that there are new splenic infarctions since 5/5/95, and the SMA is no longer apparent. This suggests the possibility of emboli as the source of bowel ischemia. Alternative considerations would include preexisting stenosis from either atherosclerosis or tumor compression which was compounded by hypotensive event resulting in ischemia and infarction. 2. Markedly low attenuation liver. The appearance is compatible with fatty infiltration. The inhomogeneous enhancement pattern also raises the question of abnormal perfusion or metastatic disease. The portal vein is patent. 3. Left nephrectomy with enlarged para-aortic nodes compatible with metastases from renal cell carcinoma. The size of the metastatic nodes is not changed appreciably since the prior study.
- Author
- Peter Anderson
- Posted on
- Thursday 1 August 2013
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- gastrointestinal, radiology
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