Small bowel obstruction and polio of right leg

Case contributed by A.Prof Frank Gaillard

Presentation

Abdominal pain

Patient Data

Age: 77
Gender: Male

The jejunum and proximal ileum are dilated with a transition point just to the right of the umbilicus where there are multiple surgical clips. The bowel is collapsed distally. The bowel wall enhances normally. There is no free fluid or free gas.

Bilateral renal cortical cysts are stable. The adrenals, spleen and pancreas are unremarkable. Stable segment 4A liver cyst and subcapsular partially calcified segment 7 lesion. Cholecystectomy noted. Pelvic surgical clips. Bibasal atelectasis in the imaged lung bases.

Sclerotic lesion in T7, T11, L1 and L3 vertebral bodies demonstrated in keeping in keeping with known prostate metastasis.

Marked loss of musculature to the right leg in keeping with known history of poliomyelitis. 

 

Bone Scan

Modality: Nuclear medicine

RADIOPHARMACEUTICAL: 99mTc MDP, 805 MBq

TECHNICAL PROCEDURE AND RESULTS

Numerous metastatic deposits are noted.

Mild increased tracer uptake on the right-hand side of the upper cervical spine and the left foot are in keeping with degenerative change with once again a left knee prosthesis noted with no abnormal periprosthetic uptake identified.

The entire right leg is atrophic and demonstrates reduced uptake, in keeping with known history of poliomyelitis. 

OVERALL IMPRESSION

Significant progression of osteoblastic metastatic disease as described.

Case Discussion

Some cases just keep on giving, with multiple abnormalities. The most unusual finding is the extreme muscular atrophy of the right lower limb, including the psoas, consistent with a known history of poliomyelitis. 

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Case Information

rID: 34145
Case created: 5th Feb 2015
Last edited: 21st Sep 2015
Inclusion in quiz mode: Included

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