E1175. Thoracic Manifestations of Abdominal Disease
  1. Joshua Knight; University of Virginia
  2. Alan Ropp; University of Virginia
  3. Juliana Bueno; University of Virginia
The physical proximity of the thoracic and abdominal cavities, as well as the inter-dependent physiology of the thoracoabdominal organs, commonly leads to shared manifestations of disease. In many cases, abnormal thoracic findings are the first cue to the presence of abdominal pathology and can provide important clues to aid in the diagnosis of abdominal diseases.

Educational Goals / Teaching Points
After reviewing this exhibit, the learner will be able to identify the most common routes of disease spread from the abdomen to the thorax, recognize the imaging findings of common thoracic manifestations of abdominal disease, and determine appropriate diagnostic imaging work-up of thoracic findings suspicious for abdominal pathology.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
A brief review of the embryology and relevant thoracoabdominal anatomy is critical to understand the interdependence between the two cavities. Multiple entities for thoracic findings of abdominal disease will be reviewed, such as anatomic variants to include vascular and lymphatic, continuity defects to include congenital and acquired, iatrogenic, neoplastic and non-neoplastic etiologies. A pictorial review of the pathophysiology and imaging findings of specific common and uncommon entities will be reviewed, to include: azygous continuation, hepatic hydrothorax, thoracic kidney, mediastinal pancreatic pseudocyst, embolized IVC filter and prostate radiotherapy seed, lipiodol embolization, metastatic renal ossification, splenosis, renal osteodystrophy, paraesophageal varices, pulmonary endometriosis, and axillary nodal metastasis of ovarian cancer. The appropriate diagnostic imaging work-up, such as specific considerations for each entity and recommendations for follow-up, if necessary, will be included. High yield take home points will be offered.

The successful identification of abnormal imaging findings that characterize thoracic manifestations of abdominal disease is critical to the general radiologist. The accurate suspicion and diagnosis of these entities and recommendations for appropriate follow up imaging should be a skill that every general radiologist should develop.