A CT scan of the chest and abdomen was performed on a patient with a history of trauma. The scan showed no abnormalities in the lungs, heart, liver, pancreas, spleen, kidneys, or bones. All other organs examined appeared normal as well, with no free fluid, masses, or fractures detected. The impression was a normal scan of the chest and abdomen for the trauma patient.
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Trauma AbdomenChest.docx
1. Name: Date: 2074-11-25
Age/Sex:
CT SCAN OF CHEST and ABDOMEN
Clinical information: Trauma
Multislice plain CT scan of chest and abdomen/pelvis performed followed by multiplanar
reformation.
B/L lungs are unremarkable. No active pulmonary lesion or mass seen.
Trachea and principal bronchi are normal.
No esophageal abnormality seen.
No significant mediastinal lymphadenopathy.
Mediastinal vascular structures are unremarkable.
Cardiac size and outline is normal.
No pleural effusion seen.
Liver : Normal in size, outline, density. IHBD is not dilated.
GB : Normal.
CBD is not dilated.
Pancreas: Normal in size, outline, density. No parenchymal calcification. MPD is not dilated.
Spleen: Normal in size, outline, density.
Kidneys : Both kidneys are normal in size, outline, density. No calculus.
B/L adrenals are defined.
UB: distended with normal outline.
Bowel loops appear unremarkable.
No free fluid in abdomen.
No fracture seen.
IMPRESSION:
- H/O trauma
- Normal scan of chest and abdomen
Dr Aabesh Koirala
MBBS, MD Radiodiagnosis
NMC 12190