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JAMA Surgery Clinical Challenge
August 2017

Massive Intra-abdominal Mass

Author Affiliations
  • 1North West Thames Deanery, London, England
  • 2George Eliot Hospital, Warwickshire, England
JAMA Surg. 2017;152(8):797-798. doi:10.1001/jamasurg.2017.1591

A 60-year-old woman was referred to the emergency department with a history of abdominal discomfort and a palpable mass in the right iliac fossa. She denied any change in her bowel habits or having experienced rectal bleeding. She had a normal appetite and had no history of weight loss. Before this admission, she was healthy, with no previous medical problems. On examination, her vital signs were within normal limits. She was mildly tender in the right iliac fossa and there was a large mobile mass, at least 10 cm in diameter, that was easily palpable in the right iliac fossa. She was initially investigated with a computed tomography (CT) scan of the abdomen (Figure 1). She underwent a colonoscopy that showed no intraluminal mucosal abnormalities or masses, but evidence of external compression at the cecum was noted.

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