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RADIOLOGY: VASCULAR: Case# 32928: NUTCRACKER PHENOMENON, LRV DISTORTION. A 28-year-old black male s/p paraplegia secondary to gunshot wound injury in 1993. He is also s/p colostomy and has history of colostomy prolapse six months ago which was surgically corrected. Patient again now presented with non-reducible colostomy prolapse and underwent surgery which revealed bowel infarction secondary to volvulus and prolapse. The colostomy was revised along with 1/3 ileal resection and sigmoid colectomy. Patient is now post-op day 11 having increased white cell count, fever and abnormal LFTs. The study is being done to rule out abscess. Comparison is made with a prior abdominal CT. The left kidney is edematous and slightly less perfused as compared to the right kidney. The left renal vein is however well visualized and opacified, but narrows as it passes under the SMA. The left testicular vein is prominent.

Peter Anderson
radiology, Vascular