Radiology Review

Dehydration Leads to Incidental Finding

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A 57-year-old man is admitted to your facility for weakness and dehydration. His medical history is significant for rectal carcinoma, diabetes, and hypertension. His family states that his oral intake has been progressively less in the past several weeks. The patient’s vital signs are stable. Overall examination demonstrates a weak, frail-appearing man with dry mucous membranes and no other acute abnormalities. Lab work reveals that his serum sodium level and BUN/creatinine ratio are slightly elevated. To facilitate hydration, administration of medications, and nourishment, placement of a nasogastric tube is ordered; this is done just prior to your arrival at the patient’s room during rounds. As per protocol, an abdominal radiograph is obtained, and the nurses ask you to check it to confirm placement. The radiograph is shown. What is your impression?


The radiograph demonstrates that the nasogastric tube is within a decompressed stomach. Normal gas pattern is noted within the bowel and colon.

Of note, however, are tiny calcifications within the right upper quadrant. This finding is suggestive of cholelithiasis—in this case, likely an incidental finding.

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