Tuesday, January 10, 2012

Interesting Imaging (5)

A 50 year-old lady with unremarkable past medical history, presented with increasing abdominal distension for 3 weeks, associated with lower limbs swelling.

CT of abdomen showed..hmm..where are all the abdominal organs? Diagnosis?


Isaac Chan said...

simple benign unilocular ovarian cyst

Crosslink said...

Looks like fluid density material and possiblities could include giant hydronephrosis or very large mesenteric or adnexal cysts, particularly if they have ruptured. CT numbers would help determine if there is any haemorrhagic component to this although it does appear simple with no layering within.

lynawan said...

liver.hepatomegaly.or hematoma?

Anonymous said...

Giant hydronephrosis.

Bismuth said...

Hepatic hydatid cyst

alpha22 said...

gross ascites?

Darren Lee said...

Thank you for the responses.

First of all, this is a large mass occupying abdominal cavity, displacing bowel loops, and the fluid density suggests a cystic lesion, probably mucinous content. There is no significant ascites in the peritoneal cavity.

This is unlikely of hepatic origin. Hepatomegaly or hepatic cyst - eventhough massive, is unlike to result in such image.

Giant Hydronephrosis is a good thought. Though rarely, it can be giant enough to cross midline but the clue is usually the contour of the contralateral kidney can be seen at the same level in the image. I've attached the links of some good case reports of it.

What's commoner is still of gynecological etiology. Hence the closest answer goes to Isaac & Crosslink - this is case of large ovarian tumour.

Good read/Images for giant hydronephrosis:

1. M Yamamoto et al. Nagoya J. Med. Sci. 1995; 58: 107 - 110

2. Ambikavathy et at. Int J Biol Med Res 2011; 2(4): 899 – 903

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