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CT Abd Splenic Cyst

Findings: A normal appearing appendix without periappendiceal fat stranding or appendicolith is identified. Enteric contrast has progressed to the ileum. Well formed stool admixed with colonic bowel gas is noted throughout the colon. The bowel is normal in caliber without evidence of intestinal obstruction. The liver, adrenal glands and pancreas are normal in appearance. A focal hypodensity relative to the adjacent enhancing parenchyma is noted along the inferior aspect of the spleen measuring 15 x 13 x 14 mm (series 3, image #28; series 601, image #61). A 7 mm interpolar right renal cyst is identified. There are no additional cysts, masses or calculi identified. There is no hydronephrosis. 5 mm hypodense nodule and lateral gallbladder wall is of uncertain etiology, most likely related to a small stone or gallbladder polyp. The pelvic organs are unremarkable. A small amount of free fluid is noted in the pelvic cul-de-sac. There are no masses or suspicious lymphadenopathy. Normal opacification of the intra-abdominal vasculature is demonstrated. The lung bases are clear. The osseous structures are unremarkable. IMPRESSION: 1. No evidence of acute appendicitis as queried. 2. Colonic stool retention without intestinal obstruction. 3. Nonspecific focal hypodensity of the spleen. Differential includes congenital cyst and hemangioma. Less likely etiologies include infarct, or neoplastic processes including lymphoma and metastatic disease. Consider follow-up CT for in 3 to 6 months to evaluate for interval change. 4. Possible gallbladder polyp versus small gallstone.