Extremely extensive new necrosis is demonstrated involving the stomach, the entire small bowel, and right side of colon extending to the splenic flexure. There is no appreciable mural enhancement. Extensive portal venous gas is demonstrated, such that an air contrast level is demonstrated in the main portal vein, with extensive gas filling of branches of the left portal vein within the liver. The descending colon and sigmoid colon appear unremarkable, with normal enhancing walls. Part of the stomach mucosa appeared to enhance. PEG in situ.
The coeliac trunk, superior mesenteric artery, and inferior mesenteric artery opacify normally, with no thromboembolism or occlusion evident. The abdomen appears distended, with compression of the IVC.
A 10 cm pelvic mass is present, which is smaller and hypodense compared to earlier CT scans from last year - ? degenerative fibroid.
The kidneys, liver, pancreas and spleen are normally perfused.
Heart, mediastinum, lungs and pleura are unremarkable in appearance.
Conclusion
Very extensive necrosis involving the stomach, small bowel and right-sided colon. Portal venous gas.