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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Contrast Enhanced Ct Of Abdomen And Pelvis. What Does This Mean?

I had a contrast enhanced CT of the abdomen and pelvis. This are the findings and i would like to know what that means:
Findings:
Included portions of the lower thorax show hypoventilatory changes at the lung bases bilaterally. There is no basal consolidation of effusion. The heart is mildly enlarged. There is artherosclerotic calcification within the coronary arteries. No pericardial effusion is noted.
Reflux of contrast into the intrahepatic IVC suggests increased right heart pressures. No focal liver lesion is
There is no definite mesenteric or retroperitoneal lymphadenopathy. No abdominal ascites, loculated collection of free intraperitoneal air is identified.
Evaluation of the vasculature shows severe severe calcified and noncalcified atherosclerosis throughout the abdominal aorta and pelvic vasculature. There is ectasia of the infrarenal abdominal aorta, measuring 2.9 cm in AP dimension and demostrating circumferential noncalcified mural plaque with rim of calcification. High-grade stenosis seen within the common, internal iliac arteries, noting critical stenosis/occlusion of the right external artery and right common femoral artery.
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I go to the hospital for abdominal pain, the doctor said that my spleen is enlarged and hurts to the touch. He said something about cirrosis and esophageal varices. They also made a sonogram, then the CT.
Fri, 11 Oct 2013
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Radiologist 's  Response
Hello there,

Your abdominal ct scan result is indeed very helpgul in the management of your case.
enlargement of the spleen and esophageal varices can very well be attributed to liver cirthosis. However, in your ct scan, the liver is normal.
The things that you feel is now clearly due to a cardiac problem. With very heavy load of blood in the right side of the heart, the pressure goes back to the vena cava giving rise to all sorts of symptoms like varices and splenomegaly that mimics an end stage liver problem.
With this ct scan result, your doctor can eliminate cirrhosis as the cause of this passive congestion but it is primarily a heart problem.
Thank you for your question. Feel free to follow up.

Dr. Eric
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Contrast Enhanced Ct Of Abdomen And Pelvis. What Does This Mean?

Hello there, Your abdominal ct scan result is indeed very helpgul in the management of your case. enlargement of the spleen and esophageal varices can very well be attributed to liver cirthosis. However, in your ct scan, the liver is normal. The things that you feel is now clearly due to a cardiac problem. With very heavy load of blood in the right side of the heart, the pressure goes back to the vena cava giving rise to all sorts of symptoms like varices and splenomegaly that mimics an end stage liver problem. With this ct scan result, your doctor can eliminate cirrhosis as the cause of this passive congestion but it is primarily a heart problem. Thank you for your question. Feel free to follow up. Dr. Eric