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Rao R. Ivatury, MD
From the Department of Surgery, Division of Trauma, Critical Care, and Emergency General Surgery, Virginia Commonwealth University Health System, Richmond.

Arch Surg. 2003;138:681.

INTRODUCTION
A 20-YEAR-OLD, emaciated man came to the emergency department with recurrent right lower quadrant pain and diarrhea. The patient had been having similar episodes for the past 5 years and was seen in several hospitals. He had recently been referred to a psychiatrist for these symptoms. A physical examination revealed a thin, cachectic individual, underdeveloped for his age, with tenderness in the right lower quadrant without peritoneal signs. A vague "fullness" was appreciated in the right upper quadrant. Laboratory results were within normal limits. A computed tomographic scan was obtained (Figure 1).

View larger version (90K): [in this window] [in a new window] Figure 1.

What Is the Diagnosis?

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A. Acute intussusception

B. Cecal volvulus

C. Appendiceal abscess

D. Cecal carcinoma

Answer

AUTHOR INFORMATION

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Corresponding author: Rao R. Ivatury, Department of Surgery, Virginia Commonwealth University Health System, 1200 E Broad St W15E, Richmond, VA 23298.

SECTION EDITOR: GRACE S. ROZYCKI, MD

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