Abdominal Hernias, Giant Colon Diverticulum, GIST, Intestinal Pneumatosis, Colon Ischemia, Cold Intussusception, Gallstone Ileus, and Foreign Bodies: Our Experience and Literature Review of Incidental Gastrointestinal MDCT Findings

Table 1

MDCT mayor criteria in differential diagnosis of incidental gastrointestinal findings.

Abdominal hernias	Internal; Left: encapsulated bowel loops at duodenojejunal junction between the stomach and pancreas to the left of the ligament of Treitz or between the transverse colon and left adrenal gland; Right: encapsulated loops laterally and inferiorly to the descending duodenum associated with a small-bowel nonrotation; the SMA; and vein drain posteriorly; External: bowel dilation and mesangial thickening. A CT scan, followed by oral iodinated contrast administration, is the best method to determine whether the sac content is intestinal and in this case to identify the intestinal type; Diaphragmatic: segmental diaphragm nonvisualization, intrathoracic herniation of viscera, “collar sign,” and peridiaphragmatic active contrast extravasation
Giant colon diverticulum	Cavity filled with gas, fluid, or stool, with a thin regular wall and no contrast enhancement except in the presence of inflammation; wall may contain calcifications in case of chronic inflammation
Gastrointestinal stromal tumors (GIST)	Mass with a soft tissue density with central areas of lower density if necrosis is present and occasionally appear as fluid-fluid levels. Torricelli-Bernoulli sign. (PET) avid tumors
Intestinal pneumatosis	Lung window is a low-density linear or bubbly pattern or combination of both and gas in the bowel wall. Abdominal CT scanning with or without contrast enhancement can show the morphology, distension, and thickness of bowel loops
Colon ischemia	Bowel wall thickening (8 mm), thumb-printing, and pericolonic stranding with or without ascites
Cold intussusception	Bowel-within-bowel and intestinal origin of underlying masses, the site and the intestinal tract involved, mesenteric vascular impairment, involvement of perivisceral fat, surrounding tissue, and locoregional lymph nodes
Gallstone ileus	Ectopic gallstone, SBO, abnormal gall bladder with complete air collection, presence of air-fluid level, or fluid accumulation with irregular wall
Foreign bodies	Shape, size, location, and depth of the impacted foreign body and the surrounding tissue can be visualized. IV contrast is not recommended