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The distal ileum is dilated to 32 mm and contains faeces-like material. There is a transition point to normal calibre terminal ileum in the pelvis. A swirling of mesenteric blood vessels is appreciated at this point. Fat stranding and a small volume of free fluid surround the distal ileum. Fecal loading within the large bowel.
The gallbladder, spleen, pancreas, right kidney and adrenals are unremarkable. Several cysts are identified within the liver, the largest is present in the right lobe and measures 36 mm x 34 mm in maximal axial dimensions. A subcentimetre hypodense lesion in the lower pole of the left kidney is too small to definitively characterise on CT.
No intra-abdominal free gas detected. Lymph nodes are not enlarged.
The lung bases are clear.
No destructive osseous lesion.
Findings are consistent with a small bowel obstruction with "small bowel faeces sign" present. Transition point in the distal ileum where there is a swirling of mesentery suggesting volvulus. No free gas to suggest perforation.