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Hello Please Explain The Lesions On The Spine,Please, Also Comment
Question: Hello
Please explain the lesions on the spine,Please, also comment on anything you see with colon and esophagus.It looks to me that a small part of the liver is going into the diaphragm and a small fissure is beside the esophagus above diaphragm,Please give your opinion if you think the fissure beside esophagus caused his barretts.Also, can you see any signs of sma syndromein these images.Thank you
Please explain the lesions on the spine,Please, also comment on anything you see with colon and esophagus.It looks to me that a small part of the liver is going into the diaphragm and a small fissure is beside the esophagus above diaphragm,Please give your opinion if you think the fissure beside esophagus caused his barretts.Also, can you see any signs of sma syndromein these images.Thank you
Hello
Please explain the lesions on the spine,Please, also comment on anything you see with colon and esophagus.It looks to me that a small part of the liver is going into the diaphragm and a small fissure is beside the esophagus above diaphragm,Please give your opinion if you think the fissure beside esophagus caused his barretts.Also, can you see any signs of sma syndromein these images.Thank you
Please explain the lesions on the spine,Please, also comment on anything you see with colon and esophagus.It looks to me that a small part of the liver is going into the diaphragm and a small fissure is beside the esophagus above diaphragm,Please give your opinion if you think the fissure beside esophagus caused his barretts.Also, can you see any signs of sma syndromein these images.Thank you
Brief Answer:
Mild end plate changes visualised in the T11 vertebral levle
Detailed Answer:
Hi,
Thanks for writing in to us.
The images are showing mild likely end plate changes in the spine at T11 vertebral level and is not a serious concern when the involved areas are small as in the image. TViewing all the images is for confirmation.
Request you to please send all CT scan images for detailed evaluation.
Regards,
Mild end plate changes visualised in the T11 vertebral levle
Detailed Answer:
Hi,
Thanks for writing in to us.
The images are showing mild likely end plate changes in the spine at T11 vertebral level and is not a serious concern when the involved areas are small as in the image. TViewing all the images is for confirmation.
Request you to please send all CT scan images for detailed evaluation.
Regards,
Above answer was peer-reviewed by :
Dr. Prasad
Brief Answer:
Mild end plate changes visualised in the T11 vertebral levle
Detailed Answer:
Hi,
Thanks for writing in to us.
The images are showing mild likely end plate changes in the spine at T11 vertebral level and is not a serious concern when the involved areas are small as in the image. TViewing all the images is for confirmation.
Request you to please send all CT scan images for detailed evaluation.
Regards,
Mild end plate changes visualised in the T11 vertebral levle
Detailed Answer:
Hi,
Thanks for writing in to us.
The images are showing mild likely end plate changes in the spine at T11 vertebral level and is not a serious concern when the involved areas are small as in the image. TViewing all the images is for confirmation.
Request you to please send all CT scan images for detailed evaluation.
Regards,
Above answer was peer-reviewed by :
Dr. Prasad
Hello
A doctor saisd he swa tissue around d2 on EUS scan,Would that be inramural or extramural (duct) he saw/ Here is secretin mrcp showing duct around d2 duodenum.Ct scan shows 2 tiny non fusing dicts.He has barretts ,reflux,constipation,fat in stool,IBS ,fatty liver (not from drinking) non working gallbladder removed (no tones or sludge) has blood in stool off and on and puking,Has no appetite with early satiety a life time as well as constipation a lifetime.Compression test also showed compression in various positions suggetive of sma syndrome.I has excessive amnitiotic fluid when pregneant as well.He also has incomplete pancreas divisium. In your opinion, could annular pancreas with divisium be causing his problems. His problems have been life long but puking and blood in stool worse now and more frequent.
He gets short of breath and is tired a lot. Also says his stomach feels weird and he feels bad every morning upon waking up.He also has hypergylcemia.One Dr said he thpught there was a cyst on bile duct from another scan (choledocal) that could also be due to annular pancreas.He can barely eat and still muct use laxatives to move his bowels.
A doctor saisd he swa tissue around d2 on EUS scan,Would that be inramural or extramural (duct) he saw/ Here is secretin mrcp showing duct around d2 duodenum.Ct scan shows 2 tiny non fusing dicts.He has barretts ,reflux,constipation,fat in stool,IBS ,fatty liver (not from drinking) non working gallbladder removed (no tones or sludge) has blood in stool off and on and puking,Has no appetite with early satiety a life time as well as constipation a lifetime.Compression test also showed compression in various positions suggetive of sma syndrome.I has excessive amnitiotic fluid when pregneant as well.He also has incomplete pancreas divisium. In your opinion, could annular pancreas with divisium be causing his problems. His problems have been life long but puking and blood in stool worse now and more frequent.
He gets short of breath and is tired a lot. Also says his stomach feels weird and he feels bad every morning upon waking up.He also has hypergylcemia.One Dr said he thpught there was a cyst on bile duct from another scan (choledocal) that could also be due to annular pancreas.He can barely eat and still muct use laxatives to move his bowels.
Hello
A doctor saisd he swa tissue around d2 on EUS scan,Would that be inramural or extramural (duct) he saw/ Here is secretin mrcp showing duct around d2 duodenum.Ct scan shows 2 tiny non fusing dicts.He has barretts ,reflux,constipation,fat in stool,IBS ,fatty liver (not from drinking) non working gallbladder removed (no tones or sludge) has blood in stool off and on and puking,Has no appetite with early satiety a life time as well as constipation a lifetime.Compression test also showed compression in various positions suggetive of sma syndrome.I has excessive amnitiotic fluid when pregneant as well.He also has incomplete pancreas divisium. In your opinion, could annular pancreas with divisium be causing his problems. His problems have been life long but puking and blood in stool worse now and more frequent.
He gets short of breath and is tired a lot. Also says his stomach feels weird and he feels bad every morning upon waking up.He also has hypergylcemia.One Dr said he thpught there was a cyst on bile duct from another scan (choledocal) that could also be due to annular pancreas.He can barely eat and still muct use laxatives to move his bowels.
A doctor saisd he swa tissue around d2 on EUS scan,Would that be inramural or extramural (duct) he saw/ Here is secretin mrcp showing duct around d2 duodenum.Ct scan shows 2 tiny non fusing dicts.He has barretts ,reflux,constipation,fat in stool,IBS ,fatty liver (not from drinking) non working gallbladder removed (no tones or sludge) has blood in stool off and on and puking,Has no appetite with early satiety a life time as well as constipation a lifetime.Compression test also showed compression in various positions suggetive of sma syndrome.I has excessive amnitiotic fluid when pregneant as well.He also has incomplete pancreas divisium. In your opinion, could annular pancreas with divisium be causing his problems. His problems have been life long but puking and blood in stool worse now and more frequent.
He gets short of breath and is tired a lot. Also says his stomach feels weird and he feels bad every morning upon waking up.He also has hypergylcemia.One Dr said he thpught there was a cyst on bile duct from another scan (choledocal) that could also be due to annular pancreas.He can barely eat and still muct use laxatives to move his bowels.
https://drive.google.com/file/d/1VQOHZPRWr_CBQzeByCrvK2fMkUt7Rv8h/view?usp=drive_web
https://drive.google.com/file/d/1VQOHZPRWr_CBQzeByCrvK2fMkUt7Rv8h/view?usp=drive_web
https://drive.google.com/file/d/1fQubXBXTU52MbfGKcmn-aCgkUyfP2G_p/view?usp=drive_web
https://drive.google.com/file/d/1fQubXBXTU52MbfGKcmn-aCgkUyfP2G_p/view?usp=drive_web
Brief Answer:
There can be multifactorial causes
Detailed Answer:
Hi,
Thanks for writing in.
There is no annular pancreas from the given images. However there is a possibility of the tissue between the common bile duct and duodenum 2nd part (extra mural) causing groove pancreatitis.
There are also concerns for the superior mesentric artery compressing the duodenum.
There can be multifactorial causes for Conners symptoms related to the pancreas and biliary tree and not any one single cause for the problems.
Please do write back with your doubts.
Regards,
There can be multifactorial causes
Detailed Answer:
Hi,
Thanks for writing in.
There is no annular pancreas from the given images. However there is a possibility of the tissue between the common bile duct and duodenum 2nd part (extra mural) causing groove pancreatitis.
There are also concerns for the superior mesentric artery compressing the duodenum.
There can be multifactorial causes for Conners symptoms related to the pancreas and biliary tree and not any one single cause for the problems.
Please do write back with your doubts.
Regards,
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
There can be multifactorial causes
Detailed Answer:
Hi,
Thanks for writing in.
There is no annular pancreas from the given images. However there is a possibility of the tissue between the common bile duct and duodenum 2nd part (extra mural) causing groove pancreatitis.
There are also concerns for the superior mesentric artery compressing the duodenum.
There can be multifactorial causes for Conners symptoms related to the pancreas and biliary tree and not any one single cause for the problems.
Please do write back with your doubts.
Regards,
There can be multifactorial causes
Detailed Answer:
Hi,
Thanks for writing in.
There is no annular pancreas from the given images. However there is a possibility of the tissue between the common bile duct and duodenum 2nd part (extra mural) causing groove pancreatitis.
There are also concerns for the superior mesentric artery compressing the duodenum.
There can be multifactorial causes for Conners symptoms related to the pancreas and biliary tree and not any one single cause for the problems.
Please do write back with your doubts.
Regards,
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi Dr XXXXXXX
Can you please explain what the peach color at the right of the heart is? It is on all of his ct scans.Could it be a block of some sort? If not, please, what do you think it is?
Thank you
Can you please explain what the peach color at the right of the heart is? It is on all of his ct scans.Could it be a block of some sort? If not, please, what do you think it is?
Thank you
Hi Dr XXXXXXX
Can you please explain what the peach color at the right of the heart is? It is on all of his ct scans.Could it be a block of some sort? If not, please, what do you think it is?
Thank you
Can you please explain what the peach color at the right of the heart is? It is on all of his ct scans.Could it be a block of some sort? If not, please, what do you think it is?
Thank you
Brief Answer:
Area in peach is likely a part of the heart and is normal
Detailed Answer:
Hi,
Thanks for writing back.
The images you have sent are processed 3D images and there is image information loss due to layering of multiple levels. I guess the area in peach is a part of the heart and is normal. However I need to see the actual black and white CT scan image to make a confirmed opinion.
Regards,
Area in peach is likely a part of the heart and is normal
Detailed Answer:
Hi,
Thanks for writing back.
The images you have sent are processed 3D images and there is image information loss due to layering of multiple levels. I guess the area in peach is a part of the heart and is normal. However I need to see the actual black and white CT scan image to make a confirmed opinion.
Regards,
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Area in peach is likely a part of the heart and is normal
Detailed Answer:
Hi,
Thanks for writing back.
The images you have sent are processed 3D images and there is image information loss due to layering of multiple levels. I guess the area in peach is a part of the heart and is normal. However I need to see the actual black and white CT scan image to make a confirmed opinion.
Regards,
Area in peach is likely a part of the heart and is normal
Detailed Answer:
Hi,
Thanks for writing back.
The images you have sent are processed 3D images and there is image information loss due to layering of multiple levels. I guess the area in peach is a part of the heart and is normal. However I need to see the actual black and white CT scan image to make a confirmed opinion.
Regards,
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Ok,I will send it to you email.Thank you
Ok,I will send it to you email.Thank you
Please check for problems with Logans colon.Other scans showed stricture according to second opinion and he also said the bowels looked grossly abnormal.Also looks like there are polyps.I think this scan also shows the patulous esophagus just left of the heart.It looks like something is pressing on the left kidney.
Sma syndrome has been a suspicion and doppler showed compression in various positions.Do you think this scan is also suspicious for sma? There is also a appendicolith and since he has IBS, do you think it would be wise to remove the stone?He also has prostate stones and varicocele.
Please advise on what you would suggest as far as surgery for XXXXXXX I read you must have reflux an average of 10 years before barretts is seen so possibly XXXXXXX was born with the patulous esophagus.One Dr said he could see tissue all of the way around transducer at d2 duodenum and his duct of wirsung is around d2.Could the patulous esophagus be in correlation with annular pancreas? I have also been told that there is a impn cyst or diverticula in the body of the pancreas; could that be causing the constipation? He must take laxatives to move his bowels.I know that is a lot but, has been a lifetime of problems that have worsened the last 4 years.Thank you very much for your time.Logans Mom
This is not the ct that showed the peach color by the heart (is no contrast) but would like it viewed for problems listed above.Thank You
Sma syndrome has been a suspicion and doppler showed compression in various positions.Do you think this scan is also suspicious for sma? There is also a appendicolith and since he has IBS, do you think it would be wise to remove the stone?He also has prostate stones and varicocele.
Please advise on what you would suggest as far as surgery for XXXXXXX I read you must have reflux an average of 10 years before barretts is seen so possibly XXXXXXX was born with the patulous esophagus.One Dr said he could see tissue all of the way around transducer at d2 duodenum and his duct of wirsung is around d2.Could the patulous esophagus be in correlation with annular pancreas? I have also been told that there is a impn cyst or diverticula in the body of the pancreas; could that be causing the constipation? He must take laxatives to move his bowels.I know that is a lot but, has been a lifetime of problems that have worsened the last 4 years.Thank you very much for your time.Logans Mom
This is not the ct that showed the peach color by the heart (is no contrast) but would like it viewed for problems listed above.Thank You
Please check for problems with Logans colon.Other scans showed stricture according to second opinion and he also said the bowels looked grossly abnormal.Also looks like there are polyps.I think this scan also shows the patulous esophagus just left of the heart.It looks like something is pressing on the left kidney.
Sma syndrome has been a suspicion and doppler showed compression in various positions.Do you think this scan is also suspicious for sma? There is also a appendicolith and since he has IBS, do you think it would be wise to remove the stone?He also has prostate stones and varicocele.
Please advise on what you would suggest as far as surgery for XXXXXXX I read you must have reflux an average of 10 years before barretts is seen so possibly XXXXXXX was born with the patulous esophagus.One Dr said he could see tissue all of the way around transducer at d2 duodenum and his duct of wirsung is around d2.Could the patulous esophagus be in correlation with annular pancreas? I have also been told that there is a impn cyst or diverticula in the body of the pancreas; could that be causing the constipation? He must take laxatives to move his bowels.I know that is a lot but, has been a lifetime of problems that have worsened the last 4 years.Thank you very much for your time.Logans Mom
This is not the ct that showed the peach color by the heart (is no contrast) but would like it viewed for problems listed above.Thank You
Sma syndrome has been a suspicion and doppler showed compression in various positions.Do you think this scan is also suspicious for sma? There is also a appendicolith and since he has IBS, do you think it would be wise to remove the stone?He also has prostate stones and varicocele.
Please advise on what you would suggest as far as surgery for XXXXXXX I read you must have reflux an average of 10 years before barretts is seen so possibly XXXXXXX was born with the patulous esophagus.One Dr said he could see tissue all of the way around transducer at d2 duodenum and his duct of wirsung is around d2.Could the patulous esophagus be in correlation with annular pancreas? I have also been told that there is a impn cyst or diverticula in the body of the pancreas; could that be causing the constipation? He must take laxatives to move his bowels.I know that is a lot but, has been a lifetime of problems that have worsened the last 4 years.Thank you very much for your time.Logans Mom
This is not the ct that showed the peach color by the heart (is no contrast) but would like it viewed for problems listed above.Thank You
https://drive.google.com/file/d/1tG4CV-B8CX89FEDbZvxPP2F9Rzo-EVXf/view?usp=drive_web
https://drive.google.com/file/d/1tG4CV-B8CX89FEDbZvxPP2F9Rzo-EVXf/view?usp=drive_web
Brief Answer:
Please give permission to access the files on google drive.
Detailed Answer:
Please give permission to access the files on google drive.
Request sent in mail.
Regards,
Please give permission to access the files on google drive.
Detailed Answer:
Please give permission to access the files on google drive.
Request sent in mail.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Please give permission to access the files on google drive.
Detailed Answer:
Please give permission to access the files on google drive.
Request sent in mail.
Regards,
Please give permission to access the files on google drive.
Detailed Answer:
Please give permission to access the files on google drive.
Request sent in mail.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I gave permission.thank you
I gave permission.thank you
Brief Answer:
ERCP can be done to study the biliary drainage and duct of Wirsung better
Detailed Answer:
Hi,
Thanks for the permission.
I shall analyse the questions asked in your previous message.
1. Other scans showed stricture according to second opinion and he also said the bowels looked grossly abnormal.Also looks like there are polyps.
The large bowel is filled with fecal mater. There is no mass lesion. A likely appendicolith is visualised in the right of the pelvis (Image 164/ 216). I would like to see a contrast image of the bowel before commenting about any significant abnormality like a stricture and polyps. In non contrast images, commenting on a stricture and polyps is difficult.
2. I think this scan also shows the patulous esophagus just left of the heart.It looks like something is pressing on the left kidney.
The esophagus is mildly patulous but there is no hiatus hernia visualised in the images. The stomach is not well distended and probably if the stomach was filled with contrast during the scan, then a hernia might be well evaluated for in the images.
The spleen is abutting the upper pole area of the left kidney and is not significant.
3.Sma syndrome has been a suspicion and doppler showed compression in various positions.Do you think this scan is also suspicious for sma?
Visualising the SMA is difficult on non contrast images, however I clearly remember an image in the previous session and that made me think of SMA compression. In this image the SMA is not opacified and the duodenum is empty so a compression cannot be well visualised.
4.There is also a appendicolith and since he has IBS, do you think it would be wise to remove the stone?He also has prostate stones and varicocele.
The appendicolith can be left as it is if there is no symptoms of acute appendicitis. The prostate calcifications are tiny and not significant. The varicocele is not well visualised in CT scan images.
In my opinion an ERCP may be done to get a clear picture of the duct of Wirsung and a sphincterotomy can be done and the symptoms of biliary pooling can be decreased. In some patients sphincterotomy might be needed 2 to 3 times.
Please ask more questions.
Regards,
ERCP can be done to study the biliary drainage and duct of Wirsung better
Detailed Answer:
Hi,
Thanks for the permission.
I shall analyse the questions asked in your previous message.
1. Other scans showed stricture according to second opinion and he also said the bowels looked grossly abnormal.Also looks like there are polyps.
The large bowel is filled with fecal mater. There is no mass lesion. A likely appendicolith is visualised in the right of the pelvis (Image 164/ 216). I would like to see a contrast image of the bowel before commenting about any significant abnormality like a stricture and polyps. In non contrast images, commenting on a stricture and polyps is difficult.
2. I think this scan also shows the patulous esophagus just left of the heart.It looks like something is pressing on the left kidney.
The esophagus is mildly patulous but there is no hiatus hernia visualised in the images. The stomach is not well distended and probably if the stomach was filled with contrast during the scan, then a hernia might be well evaluated for in the images.
The spleen is abutting the upper pole area of the left kidney and is not significant.
3.Sma syndrome has been a suspicion and doppler showed compression in various positions.Do you think this scan is also suspicious for sma?
Visualising the SMA is difficult on non contrast images, however I clearly remember an image in the previous session and that made me think of SMA compression. In this image the SMA is not opacified and the duodenum is empty so a compression cannot be well visualised.
4.There is also a appendicolith and since he has IBS, do you think it would be wise to remove the stone?He also has prostate stones and varicocele.
The appendicolith can be left as it is if there is no symptoms of acute appendicitis. The prostate calcifications are tiny and not significant. The varicocele is not well visualised in CT scan images.
In my opinion an ERCP may be done to get a clear picture of the duct of Wirsung and a sphincterotomy can be done and the symptoms of biliary pooling can be decreased. In some patients sphincterotomy might be needed 2 to 3 times.
Please ask more questions.
Regards,
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
ERCP can be done to study the biliary drainage and duct of Wirsung better
Detailed Answer:
Hi,
Thanks for the permission.
I shall analyse the questions asked in your previous message.
1. Other scans showed stricture according to second opinion and he also said the bowels looked grossly abnormal.Also looks like there are polyps.
The large bowel is filled with fecal mater. There is no mass lesion. A likely appendicolith is visualised in the right of the pelvis (Image 164/ 216). I would like to see a contrast image of the bowel before commenting about any significant abnormality like a stricture and polyps. In non contrast images, commenting on a stricture and polyps is difficult.
2. I think this scan also shows the patulous esophagus just left of the heart.It looks like something is pressing on the left kidney.
The esophagus is mildly patulous but there is no hiatus hernia visualised in the images. The stomach is not well distended and probably if the stomach was filled with contrast during the scan, then a hernia might be well evaluated for in the images.
The spleen is abutting the upper pole area of the left kidney and is not significant.
3.Sma syndrome has been a suspicion and doppler showed compression in various positions.Do you think this scan is also suspicious for sma?
Visualising the SMA is difficult on non contrast images, however I clearly remember an image in the previous session and that made me think of SMA compression. In this image the SMA is not opacified and the duodenum is empty so a compression cannot be well visualised.
4.There is also a appendicolith and since he has IBS, do you think it would be wise to remove the stone?He also has prostate stones and varicocele.
The appendicolith can be left as it is if there is no symptoms of acute appendicitis. The prostate calcifications are tiny and not significant. The varicocele is not well visualised in CT scan images.
In my opinion an ERCP may be done to get a clear picture of the duct of Wirsung and a sphincterotomy can be done and the symptoms of biliary pooling can be decreased. In some patients sphincterotomy might be needed 2 to 3 times.
Please ask more questions.
Regards,
ERCP can be done to study the biliary drainage and duct of Wirsung better
Detailed Answer:
Hi,
Thanks for the permission.
I shall analyse the questions asked in your previous message.
1. Other scans showed stricture according to second opinion and he also said the bowels looked grossly abnormal.Also looks like there are polyps.
The large bowel is filled with fecal mater. There is no mass lesion. A likely appendicolith is visualised in the right of the pelvis (Image 164/ 216). I would like to see a contrast image of the bowel before commenting about any significant abnormality like a stricture and polyps. In non contrast images, commenting on a stricture and polyps is difficult.
2. I think this scan also shows the patulous esophagus just left of the heart.It looks like something is pressing on the left kidney.
The esophagus is mildly patulous but there is no hiatus hernia visualised in the images. The stomach is not well distended and probably if the stomach was filled with contrast during the scan, then a hernia might be well evaluated for in the images.
The spleen is abutting the upper pole area of the left kidney and is not significant.
3.Sma syndrome has been a suspicion and doppler showed compression in various positions.Do you think this scan is also suspicious for sma?
Visualising the SMA is difficult on non contrast images, however I clearly remember an image in the previous session and that made me think of SMA compression. In this image the SMA is not opacified and the duodenum is empty so a compression cannot be well visualised.
4.There is also a appendicolith and since he has IBS, do you think it would be wise to remove the stone?He also has prostate stones and varicocele.
The appendicolith can be left as it is if there is no symptoms of acute appendicitis. The prostate calcifications are tiny and not significant. The varicocele is not well visualised in CT scan images.
In my opinion an ERCP may be done to get a clear picture of the duct of Wirsung and a sphincterotomy can be done and the symptoms of biliary pooling can be decreased. In some patients sphincterotomy might be needed 2 to 3 times.
Please ask more questions.
Regards,
Above answer was peer-reviewed by :
Dr. Yogesh D
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