CT hypoperfusion complex from pyelonephritis
Diagnosis almost certain
Updates to Case Attributes
Title
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Diagnostic Certainty
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.
Age
changed from 34 to 35 years.
Systems changed:
Updates to Study Attributes
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Findings
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Numerous signs of shock/visceral hypoperfusion:
- Bilateral hyperenhancing adrenal glands
- Hyperenhancing, thickened small bowel mucosa
- Mottled enhancement of the liver and spleen on portal venous phase, which becomes homogeneous on delayed phase
- Gallbladder wall thickening
Surprisingly, the IVC is round rather than flattened due to ongoing fluid resuscitation.
Periportal Periportal oedema and pericholecystic free fluid.
Small Small volume of right retroperitoneal fluid.
Asymmetric enhancement of the kidneys, less on the right with multiple peripheral wedge-shaped regions of reduced/non-enhancement. Multiple tiny bilateral non-obstructive renal calculi. No ureteric calculi. No hydronephrosis. Incidental note of double right renal veins and retro-aortic left renal vein.