Peritoneal inclusion cyst
MHC gene deletion (i.e. no functioning immune system); background of gastrectomy, colectomy; presents with lower back pain radiating to left ASIS and left thigh as well as lower abdominal pain ?paravertebral abscess +/- intra-abdominal abscess.
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Superior to the bladder and uterus is a complex, low-density lesion with internal septae. It lies adjacent to the sigmoid anastomotic sutures but appearance is atypical for a fluid collection related to an anastomotic leak. Associated pelvic and abdominal free fluid and the bowel loops are displaced superiorly out of the pelvis.
The patient went to MRI (not shown), which also showed features of a peritoneal inclusion cyst.