© 2005 by BMJ Publishing Group Ltd & British Society of Gastroenterology
EDITOR'S QUIZ: GI SNAPSHOT
Clue to a more serious diagnosis
1 Department of General Surgery, Hotel Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
2 Department of Cardiovascular and Thoracic surgery, Hotel Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
3 Department of Gastroenterology, Hotel Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
Correspondence to:
Correspondence to:
Dr B Abboud
Department of General Surgery, Hotel Dieu de France Hospital, Alfred Naccache Street, Beirut, Lebanon; dbabboud@yahoo.fr
Keywords: gastric pneumatosis; peritonitis; pneumoperitoneum
| The first 100% of the full text of this article appears below. |
An 82 year old non-diabetic man on haemodialysis three times a week presented with a two day history of epigastric pain with nausea, fatigue, and a cold painful left lower extremity. He complained of chronic claudication after an ambulatory distance of 50 m and a two month history of postprandial abdominal discomfort. Physical examination revealed isolated epigastric tenderness, absent left femoral pulse, and a cold insensitive left lower extremity. Rectal examination was normal. Leucocytosis of 34 000/mm3 (80% polymorphonuclear) was the only striking biological abnormality. Immediate enhanced computed tomography scan of the abdomen (fig 1
) was obtained and upper endoscopy was performed (fig 2).
[in a new window] Figure 1 Enhanced computed tomography scan of the abdomen.
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[in a new window] Figure 2 Upper endoscopy.
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How can these examinations help in integrating the whole clinical syndrome?
See page 487 for answer
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EDITOR’S QUIZ: GI SNAPSHOT
Gut 2005 54: 487.[Extract] [Full Text] [PDF]
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