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JAMA Surgery Clinical Challenge
September 2016

Young Adult With Abdominal Lump

Author Affiliations
  • 1Department of Surgical Gastroenterology, Pushpawati Singhania Research Institute, New Delhi, India
  • 2Department of Gastroenterology and Hepatology, Pushpawati Singhania Research Institute, New Delhi, India
JAMA Surg. 2016;151(9):873-874. doi:10.1001/jamasurg.2016.0989

A young adult presented with a progressively growing abdominal lump that left him feeling a dull ache and heavy. Ten weeks previously, he was hospitalized and conservatively managed for acute pancreatitis. He had a history of prolonged alcohol abuse. A physical examination revealed stable vital signs and a normothermic, nontender, nonpulsatile, fixed lump in his upper abdomen (Figure, A). A routine blood test revealed leukocytosis (white blood cell count of 12 000/μL[to convert to ×109 per liter, multiply by 0.001]), and his liver and kidney function test results were unremarkable. His serum amylase level was 487 U/L (normal range, 28-100 U/L [to convert to microkatals per liter, multiply by 0.0167]). A contrast-enhanced computed tomography (CT) scan of his abdomen was performed (Figure, B).

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