Findings, case of 62 y/o man, autopsy, Hx alcohol abuse, small bowe

Imaging Findings

Prior to the patient's surgery in 1988, an abdominal/pelvic CT scan was obtained without intravenous contrast. This exam showed a small bowel loop in the left upper quadrant of the abdomen with irregular thickening of the circumference and areas of ulceration (arrow). An enlarged lymph node (arrow) was also seen just medial to the mass, and a small amount of ascites was present.

An upper GI series with small bowel follow-through was also performed in 1988 prior to the patient's surgery. This showed a 6 cm ulcerating and nodular mass in the proximal jejunum just distal to the ligament of Trietz (arrow).

Three years later (1991), an abdominal/pelvic CT scan with intravenous contrast was performed after the patient developed rectal bleeding. This study shows a 6x7x8cm heterogeneously enhancing mesenteric mass in the mid abdomen (arrow). Surgical clips are embedded within the mass. In addition, a 5x7cm heterogeneously enhancing mass is visible in the pancreatic head (arrow). Multiple round, low attenuation lesions are visible in the liver (arrow), and there is abundant ascites (arrow). There is also splenic (arrow), portal (arrow), and superior mesenteric vein thrombosis (arrow).

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