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Pathology of the abdominal wall on computed tomography
Last reviewed: 23.04.2024
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Enlarged lymph nodes
Abdominal wall abnormalities are most often localized in the inguinal region. Enlarged to 2 cm in diameter, the lymph nodes should not be considered pathologically altered. Large conglomerates of lymph nodes are characteristic of non-Hodgkin's lymphoma and are less common in lymphogranulomatosis (Hodgkin's disease).
In differential diagnosis, one must keep in mind the hematoma of the inguinal region at the point of femoral artery puncture after performing selective angiography by Seldinger.
Abscesses
In the subcutaneous fat of the gluteal region, foci of necrosis may occur at the sites of intramuscular injections. After the transferred inflammatory process, residual phenomena appear in the form of formations of increased density with a clear contour and partial calcification.
From the buttock muscles through the ischium-rectal fossa, the abscess can spread into the pelvic region. After the diffuse infiltration of the gluteus muscles with the surrounding edema, softening of the tissues may occur and, depending on the size and localization of the lesion, it is possible to involve the sciatic nerve in the process.
Large metastases tend to germinate in the muscles of the abdominal wall and often have central necrosis of reduced density. Contrast enhancement is a sign of a malignant or inflammatory process. If the degree of contrast enhancement is questionable, the density of the area of interest should be compared before and after the contrast agent is injected.
Metastases in the abdominal wall can not be determined until they get an infection and an abscess develops. At the same time, it is punctured and drainage is put. The second metastasis, located below, on the right side of the abdominal wall, was not initially detected. This is due to the fact that the clinical picture was caused by a nearby abscess.
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