Presentation
Pre-op workup for renal re-transplant
Patient Data
Non contrast due to ESRF.
Atrophic right native kidney and atrophic hydronephrotic left native kidney similar in appearance to the previous study. The left proximal hydroureter is also stable. Evidence of previous bilateral iliac fossa surgery at the site of previous transplants.
Both CIAs appear narrowed with a maximum diameter of 5 mm. The right CIA contains mild posterior wall calcific atheroma extending from the aortic bifurcation. Both EIAs are also narrowed, measuring 5 mm maximum diameter. No calcific atheroma detected. The left EIA is ill-defined as it passes through the left iliac fossa surgical bed.
Stranding within the lower anterior abdominal wall subcutaneous tissue is more well defined than on the previous study. There has been development of new well-circumscribed regions of fatty attenuation within the right aspect of the lower and anterior abdominal wall subcutaneous fat, presumably representing fat necrosis. No fluid collections or calcification is evident. The left inferior epigastric artery is heavily calcified. Several branches of both internal iliac arteries are also heavily calcified.
Case Discussion
Abdominal wall calciphylaxis presenting as fat necrosis.
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