Can you guess the diagnosis using this radiology report?">
APRIL 22, 2013

Can you guess the diagnosis using this radiology report?

Here are some excerpts from a radiology report I received. I left out some portions that were not pertinent and I highlighted some of the better parts in bold. My comments are in brackets.

This was in reference to a CT scan of the abdomen for abdominal pain.

Free peritoneal air is present. Proximal small bowel loops are dilated to about 4 cm in diameter. In the lower abdomen and upper pelvis there is a region of edema and a change in caliber of the diameter of the bowel consistent with bowel obstruction. This edema also surrounds the sigmoid colon. There are diverticula and diverticulitis is a consideration. Perforated diverticulitis is also another consideration for the free air. There are some collections of air along the right side of the sigmoid colon which may be extraluminal or perhaps some prominent diverticula. A small abscess in this region is a consideration. There is diffuse edema in the lower omentum.

No abnormal masses are seen in the pelvis. No significant amount of free pelvic fluid is present. [Is there an insignificant amount of fluid?]

No appendicitis. No diverticulitis. No free air.[!]

IMPRESSION: Proximal small bowel obstruction. Questionable diverticulitis with questionable small abscess adjacent to the sigmoid colon. Pneumoperitoneum [“Pneumoperitoneum” means free air in the abdominal cavity.]

Is there diverticulitis? Is there free air? What the hell is going on?

Of course, I examined the patient and looked at the images myself.

At least the radiologist used the correct plural form of the word “diverticulum.” See my previous post on this topic.

Skeptical Scalpel is a recently retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last two years, he has been blogging at and tweeting as @SkepticScalpel. His blog averages over 900 page views per day, and he has over 5400 followers on Twitter.

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