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Impression:

No CT evidence of acute intra-abdominal pathology.

No evidence of appendicitis. Descending and sigmoid colon
diverticulosis without evidence of diverticulitis.

2 cm low-density lesion with peripheral discontinuous enhancement
most likely representing a benign hemangioma. Clinical aspects of the
case will determine if further characterization with nonemergent MRI
is warranted.

Attending physician note:

I have personally reviewed the images and resident’s interpretation
thereof and agree with the findings.
–

CT ABDOMEN AND PELVIS WITH CONTRAST

Clinical history: Diffuse lower right rib pain and upper quadrant
pain.

Technique: A CT scan of the abdomen and pelvis was performed from the
lung bases to the pubic symphysis. Dose reduction techniques were
utilized including kVp/mA dose modulation based on patient size
and/or iterative reconstruction.
Contrast: 100 mL Isovue 370. Enteric: Oral contrast

Radiation dose estimate: 526 mGycm.

Comparison: Ultrasound abdomen dated May 14, 2015

Findings:
Limited lower chest:
Visualized heart and pericardium: Unremarkable
Lung bases: No infiltrate

Abdomen:
Liver: Normal size. There is a 2 cm segment 6 low-attenuation lesion
with peripheral discontinuous nodular enhancement likely representing
hemangioma (series 2 image 51).
Portal and hepatic veins: Patent
Bile ducts: No intrahepatic biliary dilatation
Gallbladder: Fluid filled
Pancreas: No solid mass
Spleen: Normal size
Adrenal glands: No mass
Kidneys: Normal size and enhancement, no hydronephrosis, no solid mass
Abdominal aorta: Normal course and caliber
Retroperitoneum: No lymphadenopathy
Peritoneum: No free air, fluid collection, or ascites

Bowel: There is no evidence of bowel obstruction. The appendix is
identified and appears normal in size. No periappendiceal
inflammatory changes are seen. Normal caliber small bowel and colon.
There is extensive descending and sigmoid colon diverticulosis
without evidence of diverticulitis..

Pelvis:
Reproductive: Prostate is not enlarged.

Urinary bladder: Normal wall thickness

Pelvic and inguinal lymph nodes: Normal size

Soft tissues: Unremarkable subcutaneous and muscular soft tissues

Bones: Productive changes are seen in the lower thoracic spine. Mild
degenerative changes are present in the lumbosacral spine.