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A 12 x 10 x 9 mm eccentric aneurysm is seen extending anterolaterally from the right side of the abdominal aorta, 1.5 cm distal to the superior mesenteric artery. This may be at the level of the right renal artery. There is significant surrounding fat stranding. The aneurysm was not present on CT.
Left iliac fossa transplant nephrectomy is noted. The previously identified well-defined collection in the surgical bed has resolved with residual fat stranding and thickening of the overlying anterior abdominal musculature. No new intra-abdominal collection is seen. No free fluid or gas.
There is progressive increased splenomegaly with a craniocaudal diameter of 13.6 cm ( previously measures 11.2 cm ). Several regions of peripheral hypoattenuation are identified, possibly still technical. No perisplenic haematoma or collection. There is normal attenuation of the splenic artery and vein.
Both kidneys are atrophic. The liver (partially imaged ) is enlarged. Pancreas and adrenals are unremarkable.
The bowel is within normal limits.
No inguinal or intra-abdominal lymphadenopathy.
Minor bibasal atelectasis/scarring.
Normal lumbar vertebral body height and alignment is maintained. Bones appear osteopenic. No acute fracture identified. The prevertebral and paravertebral soft tissues are unremarkable.
The appearances are concerning for a mycotic aneurysm, at the origin of the native right renal artery. Vascular referral recommended. Unit notified.
Bilateral fusiform dilatation of the common iliac arteries also noted.
Hepatosplenomegaly, non-specific, but a lymphoproliferative disorder including lymphoma needs to be considered.
No intra-abdominal collection identified.