Reason for Ultrasound:
Anorexia, wt. loss, abdominal mass palpable and visible on radiographs.
Liver: The liver
subjectively seemed enlarged with rounded margins. The liver was isoechogenic
to the spleen and kidneys. The architecture of the liver appeared normal.
Gall Bladder: The
gall bladder was normal in appearance and of moderate to small size.
Vascular: NSF
Stomach: NSF
Spleen: NSF
L. Kidney: NSF.
The left kidney measured approx. 4.5 cm from pole to pole in the sagittal view,
within normal limits.
R. Kidney: NSF.
The right kidney measured approx. 4.5 cm from pole to pole in the sagittal view,
within normal limits.
L. Adrenal: NSF
R. Adrenal: NSF
Urinary Bladder:
NSF. The urinary bladder was moderately full.
Lymph Nodes: There
appeared to to an enlarged LN, measuring approx. 1.5 cm in diameter, associated
with the abdominal mass. No other enlarged LN's were noted.
UG: N/A
Small Intestine:
The abdominal mass is associated with the small intestine. The affected segment
of small intestine measured approx 3.0 cm in diameter and at least 7.0 cm in
length. Small intestine leading into the affected segment is variably dilated
but normal in architecture, suggesting partial obstruction. In the affected
segment, the normal architecture is disrupted. Normal small intestine appeared
to be leaving aborally from the affected segment. I was not able to connect
the mass to the colon, suggesting it is jejunal in origin. Other parts of the
small intestine were normal in structure and size.
Colon: NSF
Peritoneum: There
was no free abdominal fluid visible.
Duodenum/Pancreas:
NSF
FNA/Biopsy: FNA's
were taken from the liver, the suspected enlarged LN and the mass.
Summary of Findings:
Abnormal findings included
a subjectively enlarged liver, a small intestinal mass and a suspected enlarged
LN closely associated with the abdominal mass. The likely R/O's for a subjectively
enlarged liver with normal to slightly increased echogenicity include fatty
infiltration due to hepatic lipidosis or diabetes mellitus and LSA. The liver
may also be normal in spite of appearances. The abnormal findings associated
with the intestinal mass are most commonly associated with carcinoma. Other
R/O's include intestinal LSA, leiomyosarcoma and leiomyoma. Hopefully, the FNA's
will help in the diagnosis. I did not see any signs suggesting intestinal perforation
today.
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