TECHNIQUE:
Portal venous CT Abdomen/Pelvis with oral contrast. Images were first acquired of the pelvis, followed by the upper abdomen with additional oral contrast and air.
FINDINGS:
Stomach wall appears thickened and polypoid, with irregular contouring especially noted at the cardia and greater curvature. Extensive soft tissue thickening of the gastric antrum and pylorus, which extends to involve the duodenum from D1 to the distal D2. The duodenal thickening appears to reflect a combination of frank wall oedema with superficially layered sessile and semi-sessile polyps. The distal jejunum and majority of the ileum appear unaffected.
Mural thickening and sessile polypoid changes are present within the terminal ileum, extending to involve the caecum, ascending colon and hepatic flexure. Peristalsis and contrast artefact obscures fine detail of the transverse colon, although there are multiple non-contiguous segments of wall thickening and clusters of sessile polyps. Descending colon is not well opacified, but appears thick walled. The rectosigmoid was not imaged.
No evidence of frank bowel obstruction or free gas.
No suspicious lymphadenopathy.
Diffuse fatty infiltration throughout the liver. Gallbladder is decompressed and thin walled.
Pancreas, spleen and adrenal glands are unremarkable.
Contrast present within the renal collecting system. No hydronephrosis or hydroureter. Large fluid density cortical cyst within the left kidney.
IMPRESSION:
Diffuse mural thickening and innumerable sessile and pedunculated polyps throughout the gastrointestinal tract, with particular involvement of the stomach, proximal duodeunm, and large bowel.