Performed at June 17 2009
Kaiser Permanente
Radiology Examination Report
abdomen and pelvis CT without contrast
History: Painful flank since 2 a.m., resolved since visit the clinic

Comparison: None

Findings: Standard CT of the abdomen and pelvis was performed without contrast.

1. There is fatty infiltration of the liver. The visualized portions of the spleen, pancreas, and adrenal glands are grossly unremarkable on this non-enhanced study.
2. There is stone in the gallbladder.
3. Multiple bilateral renal cysts are seen, some of which are exophytic.
4. There is a 4-mm non-obstructing stone in the left kidney midpole.
5. Mild right hydroureteronephrosis is seen.
6. No left hydronephrosis or hydroureter identified.
7. There is a 6 mm stone in the urinary bladder, immediately adjacent to the right ureterovesical junction, probably representing a stone recently passed into the bladder.
8. The prostate is moderately enlarged, measuring 5.4 by 4.4 cm in axial plane.
9. No free fluid is seen in the abdomen or pelvis.
10. No evidence of small bowel obstruction.
11. The appendix is normal in appearance.
12. Multiple lucent lesions with 'corduroy-like' sclerotic densities are seen in the vertebral bodies, most likely representing hemangiomas. The largest is at L2, which involves the entire vertebral body.
13. Degenerative changes are seen in the lumbar spine.
14. No abnormalities noted in the visualized lung bases.

Impressions:

1. Mild right hydroureteronephrosis, and a subcentimeter stone in the urinary bladder, immediately adjacent to the right ureterovesical junction, probably representing a stone recently passed into the bladder.
2. Fatty liver.
3. Cholelithiasis.
4. Moderately enlarged prostate.
5. Multiple lucent lesions with corduroy-like sclerotic densities in vertebral bodies, most likely representing hemanginomas. The largest is at L2, which involves the entire vertebral body.
 
The study was flagged in radiology inbox. Action required.


Physicians comments:

Your recent CT scan showed kidney stones, one that was in the kidney and one that appeared to have passed into the bladder, the likely cause of your recent pain. Let me know if this has not resolved.
 
There were a few other incidental findings, namely Gallstones, fatty liver, enlarged prostate, and hemangiomas, which are blood collections that are not dangerous.
An official copy will be coming in the mail.I've included info below for you to read.
If you are interested in Prostate Cancer Screening, that is something that we can do with a rectal exam and/or PSA blood testing.
Please schedule a visit if you are interested in this.
 
Fatty liver is likely due to your weight. Sometimes the fat can irritate the liver. Slowly losing weight, no greater than 1.5 pounds per week can help with this.
 
Call or email if questions.
Take Care,
Dr. Lee

 
Your Kaiser Permanente Care Instructions
 
1. Gallstones: After Your Visit
Your Care Instructions
 
Gallstones are stones made of cholesterol and other substances that form in the gallbladder or bile duct. The gallbladder is a small sac located just under the liver. It stores bile released by the liver. Bile helps you digest fats. Gallstones also can form in the common bile duct, the tube that carries bile from the gallbladder and the liver to the small intestine. Gallstones may be as small as a grain of sand or as large as a golf ball.
 
Gallstones that cause symptoms usually are treated with surgery to remove the gallbladder. If the first attack of Gallstone pain is mild, it is often safe to wait until you have had another attack before you consider having surgery. Talk with your doctor about whether you need surgery.
 
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. Its also a good idea to know your test results and keep a list of the medicines you take.
 
How can you care for yourself at home?
 
- Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
- Avoid foods that cause symptoms, especially fatty foods. These can cause Gallstone pain.
- You may need more tests to look at your gallbladder.
 
When should you call for help?
 
Call your doctor now or seek immediate medical care if:
 
- You have a new fever.
- Your belly pain gets much worse, or you have new or different pain.
- Your skin or the white parts of your eyes turn yellow.
- You have light-colored stools and dark urine.
 
Watch closely for changes in your health, and be sure to contact your doctor if:
 
- You are not feeling better within 1 day.
 
Where can you learn more?
 
Go to http://www.kp.org Enter X038 in the search box to learn more about "Gallstones: After Your Visit".
 
This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Care instructions adapted by Kaiser Permanente from Healthwise, Incorporated 2008. Healthwise disclaims any warranty or liability for your use of this information.
 
Your Kaiser Permanente Care Instructions

 
2. Prostate Cancer Screening:
 
After Your Visit Your
Care Instructions
 
The prostate gland is a small, walnut-shaped organ that lies just below a man's bladder. It surrounds the urethra, the tube that carries urine from the bladder out of the body through the penis. Prostate cancer is the abnormal growth of cells in the prostate. Cancer of the prostate is the second most common type of cancer in men. (Skin cancer is the most common).
 
Most cases of prostate cancer occur in men older than 65. The disease runs in families and is more common in African-American men. It also tends to be more common in men who eat a high-fat diet. Prostate cancer may be curable if you find and treat it in its early stage. However, not all cases of prostate cancer are treated. Depending on how old you are and how slowly the cancer is growing, prostate cancer may not shorten your life. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. Its also a good idea to know your test results and keep a list of the medicines you take.
 
What are the screening tests for prostate cancer?
 
There are two screening tests for prostate cancer: the prostate-specific antigen (PSA) test and the digital rectal exam.
 
- The PSA test measures the level of prostate-specific antigen in your blood. A high PSA level may mean that you have an enlargement, infection, or cancer of the prostate.
- The digital (finger) rectal exam checks for abnormalities in the pelvic area, including the prostate. The doctor inserts a lubricated, gloved finger into the rectum.
- Neither of these tests is used on its own to diagnose prostate cancer. If these tests point to cancer, your doctor will probably recommend a prostate biopsy.
 
How is prostate cancer diagnosed?
 
In a biopsy, small tissue samples are taken from the prostate. A doctor looks at the samples under a microscope for signs of cancer, infection, or other problems. The results of a biopsy can be used to diagnose prostate cancer.
 
What are the pros and cons of screening?
 
Neither a PSA test nor a digital rectal exam can tell you for sure that you do or do not have cancer, but they can help you decide whether you need more tests, such as a prostate biopsy. Screening may be useful because most men with prostate cancer do not have symptoms. Without Prostate Cancer Screening, you may not know that you have cancer until it is more advanced and harder to treat.
 
Prostate cancer tends to develop late in life and grows slowly. For many men, it does not shorten their lives. Some experts advise screening only for men who are at high risk. Talk with your doctor about whether screening is right for you.
 
When should you call for help?
 
Watch closely for changes in your health, and be sure to contact your doctor if:
 
- You have blood or pus in your urine.
- Urinary symptoms, such as having trouble urinating, come on quickly, last longer than 2 months, or are bad enough that you want help.
 
Where can you learn more?
 
Go to http://www.kp.org Enter R550 in the search box to learn more about "Prostate Cancer Screening: After Your Visit".
 
This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Care instructions adapted by Kaiser Permanente from Healthwise, Incorporated 2008. Healthwise disclaims any warranty or liability for your use of this information.


 
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