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A 40 year old man presented to the emergency department with a six day history of intermittent abdominal left lower quadrant pain, nausea, vomiting, and constipation. The patient admitted excessive fruit and vegetable consumption for the past six months. His past medical history was not revealing.
On physical examination the abdomen was moderately distended, soft, and with normal bowel sounds. A tender 8×6 cm mass was palpable in the left lower quadrant. Digital rectal examination, laboratory tests, and chest x ray (fig 1) were unremarkable.
What does this plain abdominal x ray show?
See page 1144 for answer
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Robin Spiller, Editor
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