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OpenAthens Shibboleth
Special Feature
August 2007

Picture of the Month—Quiz Case

Author Affiliations



Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Pediatr Adolesc Med. 2007;161(8):773. doi:10.1001/archpedi.161.8.773

A 13-year-old girl presented with 5 days of abdominal pain that originated in her right upper quadrant and progressed to her epigastrium. She denied experiencing nausea, vomiting, diarrhea, loss of appetite, fevers, or chills. She was afebrile. Her abdomen was tender to palpation in the midepigastrium, but without rebounding or guarding. White blood cell count and lipase and liver function test results were normal. Her weight was 64.7 kg (~ 90th percentile for age), and her height was 158 cm (~ 50th percentile). Figures 1 and 2 are images from her abdominal computed tomographic (CT) scan.

Figure 1.
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Axial computed tomography through the patient's upper abdomen at the level of the kidneys. Triangular area of radiodense omental fat (arrows) is seen anteriorly within the right abdomen.

Figure 2.
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Two-dimensional coronal reconstruction of abdominal computed tomography. Note the position of the triangular hazy gray density (arrows) in relation to the stomach and the transverse colon (arrowhead).

What is your diagnosis?