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Файл:Ординатура / Хирургия / @xirurgi_2025 / @xirurgi_2025 - 386 - файл
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ij
gh
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J. H. Bortz
kl
Fig. 18.2
descending coronary artery (open black arrow) and fatty
liver. A=aorta. Distal oesophagus (open white arrow). (h)
2D axial view showing pleural thickening base of lungs
(open white arrows). 1=liver; 2=right ventricle; 3=left
ventricle; 4 = aorta. (i) Distended gallbladder = 1;
Duodenum=2; A=aorta; RK=right kidney; LK= left
(g) 2D axial shows calcication right posterior
kidney. (j) 2D coronal view shows four gallstones (circle).
C= caecum; DC = descending colon. (k) Solitary calcied gallstone (open white arrow). LLL=left lobe of liver;
RLL = right lobe of liver; P = pancreas; A = aorta;
LK=left kidney; S=spleen. (l) Multiple gallstones with
gas (circle). RLL=right lobe of liver; A=aorta.

op
18 Extracolonic Findings, Their Clinical Signicance, andtheRole ofOpportunistic Screening
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mn
249
qr
Fig. 18.2
RK=right kidney; LK=left kidney; A=aorta. (n) Milk
of calcium bile (open white arrow). Right adrenal gland
(circle); RLL=right lobe of liver; P=pancreas; A=aorta;
S=spleen. (o) Liver granuloma (open black arrow). Small
pericardial effusion (open white arrow). (p) Liver cysts
(m) Multiple calcied gallstones (circle).
(open black arrows). A=aorta; S=spleen; 1=stomach.
(q) Liver cyst right lobe (open black arrow). A=aorta. (r)
Ill-dened low density area right lobe (open white
arrows). Differential diagnosis is metastasis versus haemangioma. Proven haemangioma. A=aorta.

250
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vw
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J. H. Bortz
u(i)
u(ii)
Fig. 18.2
liver; RL= right lobe of liver; 1= ssure for ligament;
P=pancreas; S=spleen; A=aorta; Right adrenal gland
(open white arrow). (t) Fatty inltration of liver. Note
marked decrease in liver density compared with spleen.
(u) (i) Normal adrenal glands E1 (circles). LK=left kidney. Compare the right adrenal with the one in
(s) Fatty inltration of liver. LL = left lobe of
Fig. 18.2u(ii). (ii) Nodule on right adrenal gland (open
white arrow). Fatty liver. (v) 2D axial showing 65mm
cyst in right kidney (open white arrow). A = aorta;
LK= left kidney. (w
white arrow) with calcication (open green arrow).
A=aorta; LK=left kidney.
) Cyst mid- pole right kidney (open

18 Extracolonic Findings, Their Clinical Signicance, andtheRole ofOpportunistic Screening
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xy
251
z
aB
aA
Fig. 18.2
A=aorta; LK=left kidney. (y) Large calculus right kidney (open black arrow). (z) Lobulated cyst right kidney
(open white arrows). LK= left kidney. (aA) Horseshoe
(x) Right lower pole renal calculus (6 mm).
kidney (open white arrows). (aB) Pyelonephritic scarring
left kidney with a small focus of dystrophic calcication
(open white arrow). RK=right kidney.

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aC aD
aE aF
J. H. Bortz
aG aH
Fig. 18.2
RK=right kidney. (aD) 2D axial view. 1=crus of diaphragm; 2 = left lobe of liver; 3 = stomach; 4 = aorta;
5=caudate lobe of liver; 6=liver; 7= peritoneal space;
8=spleen; 9=granulomata. (aE) 2D axial view showing
calcication of body of pancreas (white arrow) due to previous pancreatitis. 1=small bowel; 2=gas in large bowel;
3= air in small bowel; 4 = head of pancreas; 5 = IVC;
(aC) Atrophic left kidney (open white arrows).
6= aorta; 7=right crus of diaphragm; 8= right kidney;
9=spleen. (aF) 2D axial view showing cyst in tail of pancreas (open white arrow). 1 = small bowel; 2 = IVC;
3=crus of right diaphragm; 4=aorta; 5=spleen. (aG) 2
D axial view showing an atrophic pancreas (open white
arrow). A=aorta. (aH) 2 D axial view shows a calcied
broid (open white arrow).

18 Extracolonic Findings, Their Clinical Signicance, andtheRole ofOpportunistic Screening
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aJaI
aK aL
253
aM aN
Fig. 18.2
(open white arrows) giving a ‘Mickey Mouse’ appearance. (aJ) 2D sagittal view shows anterior calcied broid
(open white arrow) causing narrowing of the sigmoid
colon (closed white arrow). (aK) 2D axial view shows a
pedunculated broid (open white arrow) with some calcication (open green arrow). (aL) 2D sagittal view shows
(aI) 2D axial view shows three calcied broids
large retroverted uterus (open white arrows). White circle=spondylolisthesis L5 with defect through pars interarticularis (open black arrow). (aM) 2D axial shows a
prolapsed broid (open white arrows). (aN) Open green
arrow shows enlarged prostate (P) pressing on bladder
(B). Note bladder wall thickening (open white arrow).

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aO aP
aQ aR
aS
J. H. Bortz
Fig. 18.2
bladder (B). Mild dystrophic calcication noted (open
green arrow). (aP) Enlarged prostate (open white arrows).
(aQ) Hydrocele right (open white arrow). Left testis nor-
(aO) Enlarged prostate (P) pressing on base of
mal. (aR) Bochdalek hernia (red arrow). 1=liver; 2=DC;
3= stomach; 4 =aorta; 5 spleen. (aS) Bochdalek hernia
containing fat (open white arrow).

18 Extracolonic Findings, Their Clinical Signicance, andtheRole ofOpportunistic Screening
https://t.me/medicina_free
255
aT(i)
aU(i)
aT(ii)
aU(ii)
aV
Fig. 18.2
tus hernia. (aU) (i) 2D axial showing urachal remnant
(open white arrow). B=bladder; Rectal catheter (circle).
(ii) 2D sagittal showing urachal tract (open white arrow)
from bladder (B) to umbilicus (open green arrow). (aV)
(aT) (i) Moderate hiatus hernia. (ii) Small hia-
aW
Bilateral small inguinal hernias (a and b) containing fat,
but no loops of bowel. 1=pectineus muscle; 2=obturator
externus. (aW) Small umbilicus hernia. Open white arrow
shows margin of the hernia. Open green arrow shows
defect in musculature.

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J. H. Bortz
aX
aY(ii)aY(i)
Fig. 18.2
green arrow). (aY) (i) Compression fracture T12 (arrow).
(ii) Healed osteoporotic fractures (open black arrows).
(aZ) (i) Spondylolisthesis L4 on L5 (closed black arrow).
Open black arrow=ununited apophysis of L5. S=sacrum.
(aX) Calcication of right iliac artery (open
aZ(ii)aZ(i)
Open white arrow shows calcied of L5/S1 disc Open
green arrow shows calcication of aorta. (ii) Lesion
sacrum (open white arrow) shows Paget’s disease.
C=rectal catheter

18 Extracolonic Findings, Their Clinical Signicance, andtheRole ofOpportunistic Screening
https://t.me/medicina_free
18.5.3 E3: Moderate Clinical
Importance
Figure 18.3a–l are examples of ECFs of moderate clinical importance.
a
b(i) b(ii)
257
Fig. 18.3 (a) 2D axial view shows heavy calcication
left anterior descending artery (open black arrow) and circumex coronary artery (closed black arrow) and calcication of thoracic aorta (open white arrow). (b) (i) 2D
coronal view showing basal lung infective changes bilat-
erally (open white arrows). (ii) 2D axial showing basal
lung changes (closed black arrows). Patient known to be
suffering from SLE (systemic lupus erythematosus).
1=liver; 2=spleen. Granules due to ingested medication
in stomach (green arrow).
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