FINDINGS:   Lower thorax: Small right-sided effusion with minimal atelectasis in the right lower lobe.    Liver and biliary tree: Diffuse hepatic steatosis. Subtle nodular  contour of the liver.   Gallbladder: Surgically absent. Common bile duct measures up to 7 mm  in diameter but tapers distally, likely secondary to  postcholecystectomy state.   Spleen: Normal.   Pancreas: Normal.   Adrenal glands: Suspicious 1.5 cm nodule in the right adrenal gland requiring further evaluation.   Kidneys and ureters: No hydronephrosis. Symmetric nephrograms with normal contrast excretion. Simple renal cyst measuring 2.3 cm in the superior pole of the left kidney, and a 1.3 cm  renal cyst in the left lower pole with attenuation of approximately 26  Hounsfield units.   Gastrointestinal tract: No bowel obstruction or evidence of bowel  wall thickening. Normal caliber appendix.   Peritoneal cavity: Trace pelvic fluid, likely physiologic. No  evidence of retroperitoneal hematoma.   Bladder: Thickened bladder wall, likely secondary to  underdistention. There is an air focus in the bladder.   Uterus and ovaries: Intrauterine device present.   Vasculature: Mild atherosclerotic changes without aneurysm.   Lymph nodes: Normal.   Abdominal wall: Subcutaneous emphysema with surrounding fat  stranding in the anterior abdominal wall. Marked pelvic floor laxity with prolapse.   Musculoskeletal: Large hematoma in the left proximal thigh region measuring 9 x 6 cm with a small region of hyperdensity. The left adductor intramuscular hematoma has decreased in size compared to prior exam, previously measuring 9 x 5 cm.
1. Left adductor intramuscular hematoma measuring 7 x 4.7 cm with a  small 6 mm region of hemorrhage seen centrally within the muscle on  early phase imaging, which did not persist on delayed imaging. This could represent a  small focus of slow, active bleeding which did not continue on  delays, versus pseudoaneurysm. No evidence of retroperitoneal  hematoma. Interval decrease in size compared to prior exam, previously measuring 9 x 5 cm.
2. Subtle nodular contour of the liver, which may represent  fibrotic/cirrhotic changes. Would correlate with clinical history,  and could consider ultrasound elastography for further evaluation.
3. Focus of subcutaneous emphysema with surrounding this fat  stranding in the anterior abdominal wall. Correlate with history of  injections.
4. Thickened bladder, likely secondary to underdistention. Correlate  with urinalysis if concern for infection. Focus of air in the  nondependent depended portion of the bladder, likely related to  instrumentation.   Preliminary results were reviewed and minor modifications were made  in this final report as follows:  Subtle nodular contour of the liver, which may represent  fibrotic/cirrhotic changes. Would correlate with clinical history,  and could consider ultrasound elastography for further evaluation.
