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Special Feature
June 2003

Image of the Month—Case

Author Affiliations

From the Department of Surgery, Division of Trauma, Critical Care, and Emergency General Surgery, Virginia Commonwealth University Health System, Richmond.



Arch Surg. 2003;138(6):681. doi:10.1001/archsurg.138.6.681

A 20-YEAR-OLD, emaciated man came to the emergency department with recurrent right lower quadrant pain and diarrhea. The patient had been having similar episodes for the past 5 years and was seen in several hospitals. He had recently been referred to a psychiatrist for these symptoms. A physical examination revealed a thin, cachectic individual, underdeveloped for his age, with tenderness in the right lower quadrant without peritoneal signs. A vague "fullness" was appreciated in the right upper quadrant. Laboratory results were within normal limits. A computed tomographic scan was obtained (Figure 1).

What Is the Diagnosis?

A. Acute intussusception

B. Cecal volvulus

C. Appendiceal abscess

D. Cecal carcinoma


Corresponding author: Rao R. Ivatury, Department of Surgery, Virginia Commonwealth University Health System, 1200 E Broad St W15E, Richmond, VA 23298.