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Elizabeth A. Mittendorf, MD; Amitabh Goel, MD; David Seaman, MD
From the Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Md (Dr Mittendorf); and the Department of Surgery, Case Western Reserve University, Cleveland, Ohio (Drs Goel and Seaman).

Arch Surg. 2004;139:907.

	Since this article does not have an abstract, we have provided the first 115 words of the full text and any section headings.

INTRODUCTION

An otherwise healthy 37-year-old woman was initially seen in the emergency department complaining of lower abdominal pain, nausea, and vomiting of 3 days' duration. She described previous episodes of right upper quadrant abdominal pain. On physical examination, she was febrile and tachycardic with lower abdominal tenderness, and her rectal examination results were Hemoccult negative. The laboratory evaluation was significant only for an elevated white blood cell count, and an abdominal radiograph revealed distended large-bowel loops. A computed tomographic scan revealed a large mass in the sigmoid colon (Figure 1).

Figure appears in full text version. Figure 1.

What Is the Diagnosis?

A. Diverticulitis

B. Colon cancer

C. Cholecystocolonic fistula

D. Foreign body

Answer

SECTION EDITOR: GRACE S. ROZYCKI, MD

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Arch Surg. 2004;139(8):908.
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