The answer
The CT shows an abnormal density behind the caecum/ascending colon.
Surrounding this abnormal density is stranding of the fat in keeping with
surrounding inflammation.
There is also a track leading from the skin in anterior midline directly
into the abdominal wall.
What the student may say
This is a section from an abdominal CT scan taken on 29 January 2003. I
cant see the patients name, but the year of birth is 1980, thus the patient was
23 when the scan was performed.
Oral contrast has been given, but I don't see any evidence of intra-venous
contrast.
There is an unusual density seen in the right loin posterior to the
caecum/ascending colon. There is stranding of the fat surrounding the density
which indicates inflammation.
Small print
If intra-venous contrast had been given then the major blood vessels in the retroperitoneum would be much brighter, here we see that they are about the same density as muscle.
Oral contrast has been given, the increased density seen in the intestine
is due to the contrast agent in the intestinal lumen.
The major abnormality in this section is in relation to the
ascending colon and not the descending colon. The ascending
colon is normally found on the patients right side and the descending colon on
the patient's left side. In this section the descending colon looks normal.
The track seen running from the anterior midline directly into the
abdominal wall is not typical for the scar normally seen at the umbilius and is
more in keeping with a healing wound. If this track is seen over a long
distance it indicates a midline incision. If it is only seen in one or two
sections then it most likely represents a laparoscopic port site.
