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  Vol. 144 No. 10, October 2009 TABLE OF CONTENTS
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Image of the Month—Quiz Case

Emad Kandil, MD; Sara King, MD; Haytham Alabbas, MD; Krzysztof Moroz, MD; Mary Wright, MD

Arch Surg. 2009;144(10):973. doi:10.1001/archsurg.2009.172-a

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

A 64-year-old woman presented to the emergency department with abdominal pain, nausea, and bilious vomiting. The patient did not have any constitutional symptoms or current concerns. She denied having bone pain, cough, or shortness of breath. Review of systems was otherwise negative in detail. Her surgical history was negative for abdominal surgery.

Abdominal examination revealed a diffuse, mildly tender, distended abdomen with hypoactive bowel sounds. The remainder of her physical examination revealed a mottled, dimpled right breast with nipple retraction and a large 5.0-cm palpable mass. No palpable axillary lymphadenopathy was appreciated. Additional evaluation in the emergency department included an abdominal computed tomographic scan with oral and intravenous contrast (Figure 1).


 
Figure appears in full text version.
Figure 1. Transition zone between proximal dilated small bowels (large arrow) and distal collapsed ones (small arrow).


The patient was admitted for . . . [Full Text of this Article]

What Is the Diagnosis?

Author Affiliations: Tulane University Medical School, New Orleans, Louisiana.



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RELATED ARTICLE

Image of the Month—Diagnosis
Arch Surg. 2009;144(10):974.
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