Case 5 - Edge of Film - Myocardial Infarction Incidental

EXAM: CT Abdomen + Pelvis w/ IV Contrast
The patient participated in written informed consent prior to the administration
of Omnipaque 350. Enteric contrast was not administered. No immediate
complication.
CLINICAL INDICATION: Chest and abdominal pain epigastric.
COMPARISON: None available.
FINDINGS:

SUPPORT DEVICES: None.
LOWER THORAX: The visualized lung bases are clear. No pericardial or pleural
effusions. Hypoattenuation of the endocardial left ventricle in the region of
the left anterior descending artery territory.
LIVER: Normal enhancement, size and contour. No nodules.
BILIARY TREE/GALLBLADDER: No intrahepatic or extrahepatic biliary ductal
dilatation. Normal gallbladder.
SPLEEN: Normal enhancement, size and contour.
PANCREAS: No ductal dilatation or focal lesions.
ADRENAL GLANDS: No nodularity.
KIDNEYS/URETERS: Symmetric enhancement. No obstructive uropathy or stones.
Hypodensity within the superior pole the right kidney measuring 12 mm and 12
Hounsfield units, likely representing simple renal cysts of (series 2, image
25). Punctate calcification within the superior pole the right kidney medially
which may represent nonobstructing renal stone. Additional subcentimeter
hypodensities within the bilateral kidneys are too small to characterize.
BLADDER: No abnormality.
GI/BOWEL: Moderate to severe fecal loading. No dilatation or inflammatory
changes.
PELVIC ORGANS: No abnormality.
LYMPH NODES: No abnormality.
PERITONEUM/RETROPERITONEUM: No drainable collection or free air.
VESSELS: No aneurysms or gross evidence for dissection . The portal vein is
patent.
BONES/SOFT TISSUES: No acute abnormality.
IMPRESSION:
1. Hypoattenuation of the endocardial left ventricle in the region of the left
anterior descending coronary artery concerning for acute myocardial infarction.
2. Nonobstructing punctate right renal stone. Simple cyst within the right
kidney with additional bilateral subcentimeter renal hypodensities which are too
small to characterize.
3. Moderate to severe fecal loading would suggest constipation.

RECOMMENDATION: None.
COMMUNICATION: Findings were discussed