EURORAD ESR

Case 15952

Heterotopic mesenteric and abdominal midline incision ossification

Author(s)
Elena Martínez Chamorro, Susana Borruel Nacenta, Laín Ibáñez Sanz, Carmen Cruz-Conde, José Carmelo Albillos Merino

Hospital Universitario 12 de octubre , Hospital Universitario 12 de octubre, Radiology Department; Avda. de Andalucia, s/n 28041 MADRID; Email:elenamartinezcha@hotmail.com
 
Patient
male, 41 year(s)
 
 
  • Figure 1
    CT on 12th-day
     

    Axial contrast-enhanced CT image shows gastric (G) dilatation. Note also the increased density of the properitoneal fat underlying the abdominal midline scar (open arrows).

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: Digital radiography; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    Axial contrast-enhanced CT image demostrates gastroduodenal obstruction with duodenal (D) dilatation and transition point in proximal yeyunal loops (arrow), which show diffuse wall thickening and small wedges of fluid...

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    MPR sagittal reconstruction shows increased density of the properitoneal fat underlying the abdominal midline scar (open arrows), without calcifications or ossifications.

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;
     
     
  • Figure 2
    CT on 35th-day.
     

    Axial CT image with positive oral and intravenous contrast demonstrates gastric (G) distension and extensive ossification of abdominal midline scar (open arrows) with cortical and trabecular bone pattern clearly seen.

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    Axial CT image demonstrates gastroduodenal obstruction with duodenal (D) distension and collapsed yeyunal loops, which showed a distorted and encapsulated appearance (circle) as well as with linear and branching...

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    Axial CT image with positive oral and intravenous contrast shows the linear calcification on the small bowel mesentery (circle)

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    MPR sagittal reconstruction depicts the linear calcification on the small bowel mesentery (arrows)

     
    Area of Interest: Abdominal wall; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    MPR sagittal reconstruction shows the progression of the ossification of the abdominal midline incision (arrows)

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;
     
     
  • Figure 3
    Follow-up CT (11 months after admission)
     

    Axial CT image with positive oral contrast depicts a greater maturation of the mesenteric bone lesion with formation of cortical and trabecular bone (arrows)

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Calcifications / Calculi;

    Axial CT image with positive oral contrast depicts a greater maturation of the mesenteric bone lesion with formation of cortical and trabecular bone (arrows)

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Calcifications / Calculi;

    Axial CT image with positive oral contrast and bone window demonstrates the presence of cortical and trabecular bone in the mesentery (arrows)

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Calcifications / Calculi;

    Maximum intensity projection image with thick slice and bone window demostrates the heterotopic mesenteric (solid arrows) and midline scar (open arrow) ossifications.

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Calcifications / Calculi;

    CT with volume rendering technique clearly illustrates the heterotopic mesenteric (open arrows) and midline scar (solid arrow) ossifications. Note the similar appearance of the heterotopic mesenteric and abdominal...

     
    Area of Interest: Gastrointestinal tract; Imaging Technique: Catheter venography; Procedure: Hysterosalpingography; Special Focus: Calcifications / Calculi;
     
     
  • Figure 4
    Abdominal X-ray (3 years later)

    Abdominal radiograph 3 years later showing mesenteric ossification on the left flank (arrows).

     
    Area of Interest: Abdomen; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Calcifications / Calculi;
     
     
Axial contrast-enhanced CT image shows gastric (G) dilatation. Note also the increased density of the properitoneal fat underlying the abdominal midline scar (open arrows).
 
Axial contrast-enhanced CT image demostrates gastroduodenal obstruction with duodenal (D) dilatation and transition point in proximal yeyunal loops (arrow), which show diffuse wall thickening and small wedges of fluid (*) between them.
 
MPR sagittal reconstruction shows increased density of the properitoneal fat underlying the abdominal midline scar (open arrows), without calcifications or ossifications.
 
Axial CT image with positive oral and intravenous contrast demonstrates gastric (G) distension and extensive ossification of abdominal midline scar (open arrows) with cortical and trabecular bone pattern clearly seen.
 
Axial CT image demonstrates gastroduodenal obstruction with duodenal (D) distension and collapsed yeyunal loops, which showed a distorted and encapsulated appearance (circle) as well as with linear and branching calcifications in perivisceral mesentery
 
Axial CT image with positive oral and intravenous contrast shows the linear calcification on the small bowel mesentery (circle)
 
MPR sagittal reconstruction depicts the linear calcification on the small bowel mesentery (arrows)
 
MPR sagittal reconstruction shows the progression of the ossification of the abdominal midline incision (arrows)
 
Axial CT image with positive oral contrast depicts a greater maturation of the mesenteric bone lesion with formation of cortical and trabecular bone (arrows)
 
Axial CT image with positive oral contrast depicts a greater maturation of the mesenteric bone lesion with formation of cortical and trabecular bone (arrows)
 
Axial CT image with positive oral contrast and bone window demonstrates the presence of cortical and trabecular bone in the mesentery (arrows)
 
Maximum intensity projection image with thick slice and bone window demostrates the heterotopic mesenteric (solid arrows) and midline scar (open arrow) ossifications.
 
CT with volume rendering technique clearly illustrates the heterotopic mesenteric (open arrows) and midline scar (solid arrow) ossifications. Note the similar appearance of the heterotopic mesenteric and abdominal midline incision ossification that the bone skeleton.
 
Abdominal radiograph 3 years later showing mesenteric ossification on the left flank (arrows).
 
 
 
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