What evidence of bowel injury is present?
Bowel wall thickening, oedema and pericolonic inflammatory change.
Which finding should be communicated to the referring clinician immediately?
Active bleeding at the rectosigmoid junction.
Rectosigmoid bowel wall thickening with mural oedema and surrounding fat stranding noted.
Active contrast extravasation on arterial phase with contrast pooling on portovenous phase images consistent active bleeding at the rectosigmoid junction. Small amount of free fluid in the pelvis and left inferior paracolic gutter.
No pneumoperitoneum to suggest perforation.
Conclusion:
- Findings are in keeping with rectosigmoid junction active bleeding.
- Rectosigmoid bowel wall thickening, consistent with direct trauma to rectum and distal sigmoid colon.