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Image of the Month—Quiz Case
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.
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).
What Is the Diagnosis?
A. Diverticulitis
B. Colon cancer
C. Cholecystocolonic fistula
D. Foreign body
Answer
SECTION EDITOR: GRACE S. ROZYCKI, MD
RELATED ARTICLE
Image of the Month—Diagnosis
Arch Surg. 2004;139(8):908.
EXTRACT
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