m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k 101 CT Abdokmen Solutions k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k101 CT Abdokmen Solutionsk o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e Hareiqbal Singh MD DMRD e m m m Professor and Head Department of Radiology Shrimati Kashibai Navale Medical College m Pune, Maharashtra, India m m o o o c c c . . . e Yasmeen Khan DeMRE e e e e Consultant r r r f Department of fRadiology f s s s k Shrimati Kashibai Nakvale Medical College k o Pune, Maoharashtra, India o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m Them Health Sciences Publisher m New Delhi | London | Philadelphia | Panama m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o Jaypee Brothers Medical Publoishers (P) Ltd. o b b b e Headquarters e e m Jaypee Brothers Medical Publishersm (P) Ltd. m 4838/24, Ansari Road, Daryaganj New Delhi 110 002, India Phone: +91-11-43574357 Fax: +91-11-43574314 m m m E-mail: [email protected] o o o Overseas Offices c c c J.P. Medical Ltd. Jaypee-Highlights Medical Publishers Inc. . . . 83, Victoria eStreet, London City oef Knowledge, Bld. 237, Clayton e SW1H 0HeW (UK) Paenama City, Panama e Phoner: +44-20 3170 8910 rPhone: +1 507-301-0496 r Fax:f +44(0)20 3008 6180 fFax: +1 507-301-0499 f s s s E-mail: [email protected] E-mail: [email protected] k k k oJaypee Medical Inc. o Jaypee Brothers Medical Publishers (P) Lotd. o 325, Chestnut Street, Suite 412 o 17/1-B, Babar Road, Block-B, Shaymaoli b Philadelphia, PA 19106, USA b Mohammadpur, Dhaka-1207 b e Phone: +1 267-519-9789 e Bangladesh e m E-mail: [email protected] m Mobile: +08801912003485 m E-mail: [email protected] Jaypee Brothers Medical Publishers (P) Ltd. Bhotahity, Kathmandu, Nepal Phone: +977-974128360m8 m m E-mail: [email protected] o o o c c c Website: www.jaypeebrothers.com . . . Website: wwew.jaypeedigital.com e e © 2016, Jeaypee Brothers Medical Publishers e e The fvirews and opinions expressed in this book are solelfy rthose of the original contributor(s)/author(s) and fr dos not necessarily represent those of editor(s) of the bsook. s kAll rights reserved. No part of this publication may bke reproduced, stored or transmitted in any form or bky oany means, electronic, mechanical, photo copyingo, recording or otherwise, without the prior permissioon in o writing of the publishers. o o b All brand names and product names usedb in this book are trade names, service marks, tradbemarks or e registered trademarks of their respectieve owners. The publisher is not associated with aeny product or m vendor mentioned in this book. m m Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be amdministered, to verify the recommended dose, formmula, method and duration of m administration, adverse effects and contra indications. It is the responsibility of the practitioner to take all appropriate safety porecautions. Neither the publisher nor the author(so)/editor(s) assume any liability for o any injury and/orc damage to persons or property arising from or relacted to use of material in this book. c This book is s.old on the understanding that the publisher is not en.gaged in providing professional medical . e e e services. If such advice or services are required, the services of a competent medical professional should e e e be sought. r r r Everfy effort has been made where necessary to contfact holders of copyright to obtain permission to f repsroduce copyright material. If any have been inadvesrtently overlooked, the publisher will be pleased to s kmake the necessary arrangements at the first oppokrtunity. k o o o o Inquiries for bulk sales may be solicited ato: [email protected] o b b b 101 CT Abdomen Solutions e e e m First Edition: 2016 m m ISBN: 978-93-5250-181-6 Printed at m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e Dedicated to r r r sf The unwearied, enduring, tolsefrant, and serene patients sf k who place themseklves in the hands of k o o o clinicians involved in research o o o b in pursuit bto alleviate their suffering b e foer restoration of health. e m m m m m m o o o c c c . Radiology is a kindergar.ten . e e e of logical rational coherent exploration and e e e r balanced learrning r f f f s and not dexterous asdroit smugness s k k k or learning egotism o o o o cultivated by fake soelf-centeredness and egoism. o b b b e e e —Hariqbal Singh m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o Prefacoe o o o b b b e e e m m m m m m The huge respoonse received following the publication oof 101 Chest X-ray Solutions o and 101 MRcI Brain Solutions, prompted us to decvelop on 101 CT Abdomen c . . . Solutionse, which will hopefully be equally accepeted by the readers. It provides e a largee bank of CT images on abdomen with ecases seen in routine practice to e morer difficult cases of interest. With these rimages in mind, it will help the CT r f f f s s s practitioner to interpret the possible diagnosis on abdominal CT during routine k k k oreporting practice. It will be an ideal reoference for anyone involved with CT imoage o interpretation. In many images, smoall arrow point is used to show the lesiono. This b is with an aim to provide better ubnderstanding for the reader. The imporbtance of e e e having a good knowledge of anatomy cannot be undermined and this has guided m m m us to include a chapter on normal anatomy of Abdomen on CT imaging. The book is meant for radiology residents, radiologists, general practitioners, other specialists, CT technical staff and those who have a special interest in CT imaging. It is meanmt for medical colleges and institutional lmibraries, departmental m and CT standaloone unit libraries. o o The bookc is a compilation of cases developedc by unified, consistent and c . . . cohesive eendeavor of the panel of radiologistes at Shrimati Kashibai Navale e Medicael College, Pune, Maharashtra, India. e e r r r f f f s s s k k k Hariqbal Singh o o o o o Yasmeen Kohan b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o Acknowledgmenots o o o b b b e e e m m m m m m We thank Profeossor MN Navale, Founder President, Soinhgad Technical Educa o tion Society cand Dr AV Bhore, Dean, Shrimati Kashicbai Navale Medical College, c . . . Pune, Maeharashtra, India, for their kind acquiesceence in this endeavor. e We eare profusely extending our gratefuleness to the consultants Varsha e Ranfgrankar, Santosh Konde, Abhijit Pawafr,r Amol Sasane, Aditi Dongre, Pooja fr s s s Shah, Shripad Kamble, Patil Dharmendra, Varsha Sonawane, and Ajinkya Kolse k k k ofor their genuine help in building up tohis educational entity. o o We are profusely gratified to tohe radiology residents Swati Shah, Voikram b Shende, Jarvis Pereira, Priya Bhbole, Prasad Patil, Punit Agrawal, Swapnbil Raut, e e e Amar Sangapwad and Prajakta Jagtap for their genuine help in correction of the m m m manuscript. Our gratitude to Anna Bansode and Sachin Babar for their clerical help. We are thankful and grateful to the God Almighty and mankind who have allowed us to havem this wonderful experience. m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m m m m o o o c c c . . . e e e e e e r r r f f f s s s k k k o o o o o o b b b e e e m m m