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Gut 2005;54:178; doi:10.1136/gut.2004.046102
Copyright © 2005 BMJ Publishing Group Ltd & British Society of Gastroenterology.
Gut 2005;54:178
© 2005 by BMJ Publishing Group Ltd & British Society of Gastroenterology

EDITOR'S QUIZ: GI SNAPSHOT

Caecal tumour with hepatic metastases?

S Rajendra1, K Kutty2

1 Division of Gastroenterology, Department of Medicine, Royal Perak College of Medicine, Ipoh, Malaysia
2 Department of Pathology, Sri Kota Hospital, Klang, Malaysia

Correspondence to:
Correspondence to:
Dr S Rajendra
Division of Gastroenterology, Department of Medicine, Royal Perak College of Medicine, 3 Jalan Greentown, 30450 Ipoh, Malaysia; shanraj@pd.jaring.my

Keywords: caecal tumour; amoebiasis; amoeboma; hepatic abscess; colorectal tumour

The first 150 words of the full text of this article appear below.

Clinical presentation

A 57 year old farmer presented with a four day history of jaundice, fever, chills, nausea, and right upper and lower quadrant pain. He had just returned from India a month earlier. There was no relevant past medical, surgical, family, or social history. Clinically, he looked wasted and had a temperature of 38.5°C. Tenderness was elicited in the right hypochondrium and there was a palpable tender colon in the right iliac fossa. Blood investigations revealed a raised erythrocyte sedimentation rate of 73 and abnormal liver function tests (bilirubin 47 µmol/l, alkaline phosphatase 314 U/l, gamma glutamyl transferase 263 U/l, aspartate aminotransferase 66 U/l, and alanine aminotransferase 108 U/l). Blood and urine cultures revealed no growth. Mantoux and human immunodeficiency virus testing was negative. Further serology for an infectious aetiology was sought.

Question

How do the computed tomography scan of the abdomen and colonoscopy images help in the diagnosis (fig 1Go)?


 


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EDITOR’S QUIZ: GI SNAPSHOT
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