Case 37
Presentation:
72 years of age, Female, with history of right upper lobe lesion. This F18-FDG PET/CT scan is requested for initial staging.
What are the findings? This study interpreted in comparison with a prior diagnistic chest CT: Right upper lobe nodule, measuring 23 mm, SUV max 17.4; this lesion was biopsied and was an Adenocarcinoma, T1c N1 M0. More anteriorly within the right upper lobe is a 7 mm mildly metabolic nodule, SUV max 2.5 ( background lung activity 1.0) , likely represents a metachronous primary, T1a if pathologically proven. 12 mm right hilar node (SUV max 2.5). Hypermetabolic left level 1 nonenlarged axillary nodes ( SUV max 5.7 measuring 8 mm), could be reactive given left-sided PICC line. An axial femoral bypass graft within the right chest wall. Distorted anatomy in the abdomen is due to frozen abdomen in this case with multiple adhesions/ventral soft tissue thickening and multiple ventral peritoneal surgical clips.
This patient had multiple co-morbidities, including history of recurrent small bowel obstruction due to adhesions, status post multiple surgeries now left with frozen abdomen, and PEG tube insertion since5 years ago.
What is frozen abdomen?
A "frozen abdomen" describes a condition where abdominal organs are adhered to each other due to the formation of dense adhesions. This typically results from previous surgeries, infections, endometriosis, or inflammatory diseases, causing restricted movement of the affected organs.