What is the cause of this patient's pain and what does it represent?
Epiploic appendagitis is inflammation/infarction of an epiploic appendage (fatty pedunculated 'lumps' scattered along the length of the large bowel); can be the result of torsion or venous occlusion.
What treatment is required?
Epiploic appendagitis is a self-limiting disease, and if recognised, only analgesia is required.
True or false: The inferior vena cava (IVC) is filled with thrombus extending from the renal veins down to the common femoral veins.
False - the IVC is enhanced above the renal arteries due to contrast-enhanced blood flowing out of the kidneys well before blood has had time to reach the legs and pelvis and return via the iliac veins to the infrarenal IVC. Often the hepatic segment of the IVC will have a three-layered appearance: left and right side are opacified, whereas the central portion is unenhanced. This should not be mistaken for thrombus.
What are the three arterial vessels which supply the vast majority of the bowel (from stomach to rectum)? Can you identify them?
Coeliac trunk (CT), the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA) supply essentially all the blood to the bowel (see annotated images which follow).
On the sagittal images, why does the aorta have a saw-tooth appearance?
Pulsation of the aorta during acquisition results in this appearance. If you knew either the speed of movement of the patient through the CT scanner or the heart rate during scanning, you could work out the other figure (only if you wanted to, and had nothing better to do, that is).
Ovoid fat density lesion with a high-attenuation margin and surrounding fat stranding, adjacent to the distal descending colon.