CT Evaluation of the Abdomen and Pelvis with and without I.V. Contrast

CT EVALUATION OF THE ABDOMEN AND PELVIS WITH AND WITHOUT I.V. CONTRAST

INDICATION FOR STUDY:         Fall.  Fractured ninth left rib.

FINDINGS:             I understand the patient has a left ninth rib fracture, which is nondisplaced and not as apparent on the CT evaluation, but it is identified on approximately image 6 of series 3.  There is no significant surrounding edema.  The remainder of the bony structures show slight chronic changes, but no other acute abnormality in the abdomen or pelvis.  In the liver, there are a few simple cysts identified, one noted in the left lobe on image 12 through 14 of series 5, which measures approximately 2 cm.  There is another one in the right lobe measuring 4 mm on image 14, another one in the right lobe more posteriorly and medially measuring 14 mm on image 17, and another one in the right lobe more laterally and inferiorly measuring 14 mm on image 22.  There is a simple cyst in the left kidney, which measures approximately 14 mm on image 27.  It is not as optimally characterized.  There is a horseshoe kidney.  There is no evidence of significant fracture or laceration to the liver, spleen, or kidneys.  There is no evidence of free fluid or free air in the abdomen or pelvis.  There is no evidence of calculi in the kidneys or gallstones.  There is no obstruction.  The remainder of the abdomen and pelvis shows no gross abnormality.  The pelvic evaluation shows no significant free fluid or free air and the bony structures show no fracture.  There is contrast in the bladder and the bladder is not significantly distended.  The bowel loops are not completely opacified.  A preliminary report was discussed with Dr. Roberts.

IMPRESSION:        Horseshoe kidney.  Simple cyst in the left kidney measuring approximately 1.4 cm.  Multiple simple cysts in the liver.  No clear evidence of significant laceration or rupture of the solid organs in the abdomen or pelvis.  The patient’s known left ninth rib fracture is identified on the CT evaluation as discussed above.  There is no free fluid or free air.  Would recommend clinical correlation or further evaluation as needed.