Editor's quiz: GI snapshot
An infrequent cause of acute left lower quadrant abdominal pain
1 Clinical Science Department, Gastroenterology Unit, "L. Sacco" University Hospital, Milan, Italy
2 Radiology, "L. Sacco" University Hospital, Milan, Italy
Correspondence to:
Dr Salvatore Greco, Clinical Science Department, Gastroenterology Unit, "L. Sacco" University Hospital, Via G.B. Grassi, 74, 20157 Milan, Italy; salvatore.greco@unimi.it
| The first 150 words of the full text of this article appear below. |
CLINICAL PRESENTATION
A 65-year-old male patient referred with acute abdominal pain in the left lower quadrant and a low grade fever (38°C) was admitted to the surgical emergency department of our institution. He was haemodynamically stable. His bowel movements were completely normal. Physical examination demonstrated localised tenderness in the left iliac fossa, but there was no peritonism. Serological studies revealed no abnormality apart from a white blood cell (WBC) count of 12x109/l and C-reactive protein (CRP; 3.0 mg/l). As a first step, abdominal and bowel ultrasound (US) without oral contrast agent was performed. A relevant US finding was the appearance of a well-delineated echogenic mass with a peripheral hypoechoic rim in the left flank; this lesion appeared small, oval and non-compressible, located anteromedial to the left colon with perienteric hypertrophied mesenteric adipose tissue, and absence of vascular flow on colour Doppler sonography (fig 1). Subsequent CT examination
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ANSWER
Gut 2008 57: 622.[Extract] [Full Text] [PDF]
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