Patient Name Heidi Question & Answer Guide (With Explanation)

This type of question evaluates analytical and critical thinking skills.

What This Question Is About

This question relates to patient name heidi and requires a structured academic response.

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Use appropriate theories and support your answer with clear reasoning.

Key Explanation

This topic involves patient name heidi. A strong answer should include explanation, application, and examples.

Original Question

Patient Name: Heidi Alston DOB: 02-01-62 Ordering Physician: Jack Webber, MD Gender: F Interpreting Physician: Charles Hanes, MD Date of Service: 07-16-XX Indication: Fever, chills, hx of diverticulitis Exam: CT of abdomen/pelvis with contrast Clinical History: Fever, chills, and elevated white blood cell count. Hx of diverticulitis. Left-sided colostomy. Poor output of colostomy. Comparison Study(s): CT of abdomen pelvis dated 08-19-XX. Technique: Following oral and IV contrast administration, helical CT examination of the abdomen pelvis is performed including delayed images through the kidneys with 100 mL of Omnipaque-300 utilized. Findings: There is minor dependent atelectasis in each lung base associated with paraseptal emphysema. Several tiny nodules are again noted in the posterior lung bases. No pleural or pericardial effusion is seen. The heart is not enlarged. A hypodense lesion is redemonstrated in the liver dome measuring 2 mm. This is nonspecific though likely a cyst. The liver is otherwise normal in appearance. The spleen, pancreas and adrenal glands are normal in appearance. The right kidney is normal in appearance. Hypodense lesions are again noted in the posterolateral mid to lower left kidney. These nonspecific though likely cysts. The left kidney is otherwise unremarkable. The tiny gallstone is questioned in the gallbladder fundus versus focal wall calcification. No evidence cholelithiasis. A left mid abdominal colostomy is redemonstrated. There is a moderate amount of stool proximal to the left colon. The rectum is decompressed. No intrinsic urinary bladder wall abnormality is noted. There is now noted a somewhat tubular low walled off fluid collection within the pelvis corresponding to the previously suggested fistula tract. This is largest in the left hemi pelvis which measures 1.9 x 1.3 x by 5 cm. Diagnostic considerations include a fistula and abscess. This extends posteriorly and in a finger-like projection to the perirectal region. No other pelvic mass or adenopathy is seen. There is no evidence of bowel obstruction. No new destructive bone lesion is seen. A small focus of sclerosis is again demonstrated within the L1 vertebral body on the right. This is nonspecific though likely a bone island. Impressions: There is now noted a somewhat tubular walled off fluid collection in the low pelvis most pronounced on the left showing evidence of a fistula. This has enlarged in the interval. The left mid abdominal colostomy status post distal colon resection. There is a moderate amount of stool within the remaining left colon. Hypodense lesions within the left kidney and liver are likely cysts Cholelithiasis versus punctuate calcification within the gallbladder fundus wall Not mentioned above is an IVC filter in place with its anchors in the region of the renal veins. Tiny nodular opacities within the lung bases are nonspecific though likely post-inflammatory. code the imaging case.

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