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Image of the Month
Jeffrey M. Nicholas, MD,MS;
Grace S. Rozycki, MD
From the Department of Surgery, Emory University School of Medicine, Atlanta, Ga.
Arch Surg. 2001;136:705-706.
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INTRODUCTION
A HEALTHY 27-year-old man had a 3-day history of left lower quadrant abdominal pain, anorexia, nausea, vomiting, and diarrhea. Physical examination results were remarkable for a temperature of 39°C with rebound tenderness and guarding in the left lower quadrant. Laboratory values were significant for a white blood cell count of 12.3 x 109/L, and abdominal x-rays showed a gas pattern consistent with an ileus. A computed tomographic scan of the abdomen is shown in Figure 1.
What Is the Diagnosis?
A. Small-bowel intussusception
B. Acute left-sided appendicitis
C. Ulcerative colitis
D. Crohn disease
E. Acute diverticulitis
Answer: Acute Left-Sided Appendicitis
Figure 1. Computed tomographic image characteristic of acute appendicitis with associated inflammatory changes. The "inflammatory mass" appears on the left side because of the presence of malrotation in this patient.
Because the patient's history and physical examination results were atypical for appendicitis, a diagnostic laparoscopy was performed. . . . [Full Text of this Article]
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This Month in Archives of Surgery
Arch Surg. 2001;136(6):618.
FULL TEXT
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