Pseudomyxoma peritonei

Case contributed by Dr Craig Hacking

Presentation

Abdominal distension. Hx of bowel surgery 2 years prior.

Patient Data

Age: 53
Gender: Male
CT

A nasogastric tube is in situ with the tip projected within the anterior gastric body.

Extensive lobular formations of low attenuation masses (HU 25) surround and encase the liver and spleen scalloping the surfaces. A separate lobular formation extends inferiorly from the level of the IMA to form a larger conglomerate within the pelvis.

There are multiple loops of distended small bowel (largest measuring 40mm diameter) involving the ileum and jejunum. No evidence of intramural gas. The large bowel is predominantly decompressed. No definite transition point can be identified. Bowel staples are noted in the right iliac fossa in keeping with previous resection.

The visualised parenchyma of the liver, spleen, kidneys, adrenal glands and pancreas appear normal. IDC in a collapse bladder. Minor right basal atelectasis is present.

Conclusion

Small bowel obstruction without a definite transition point. This is likely due to adhesions from the extensive lobular formations of fluid density consistent with pseudomyxoma peritonei.

Case Discussion

The patient had a history of bowel resection for appendiceal mucinous adenocarinoma.

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Case information

rID: 39965
Case created: 29th Sep 2015
Last edited: 26th Feb 2017
Inclusion in quiz mode: Included

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