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A 29-year-old man of Moroccan origin, with a 3-year history of intermittent right lower quadrant pain, presented with a recent attack of right lower abdominal pain. The patient also reported nausea and vomiting. Earlier consultations had not provided a diagnosis.The patient had no history of previous surgery or serious illness. On physical examination the abdomen was tender to palpation without peritoneal signs. His temperature was 38.4°C. Laboratory examinations showed a C-reactive protein (CRP) of 28 mg/l and a white blood cell count of 10.4×109/l. Further blood tests were unremarkable. Abdominal ultrasound was performed (fig 1, Aloka SSD-5500).
What abnormalities does the ultrasound image show? What is the likely diagnosis?
See page 10.1136/gut.2006.113233a for answers
Competing interests: None.
Patient consent: Informed consent was obtained for publication of the person’s details and figures in this report.
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