A 37-year-old man with Crohn disease, quiescent since an ileal resection and end ileostomy followed by elective ileostomy closure 10 years ago, came to the emergency department with a 2-month history of crampy abdominal pain in both lower quadrants associated with a weight loss of 11 kg, fevers and chills, mild nausea and vomiting, and diarrhea following a recent trip to Mexico. On examination, he had a palpable 5 × 7-cm mass in the right lower quadrant. Computed tomographic evaluation of the abdomen was performed (Figure).
Computed tomographic scan of the abdomen.
A. Double intussusceptions of the descending colon
B. Enterorectus fistula
C. Gastrointestinal stromal tumor of the intestine
D. Duplication cyst of the small intestine
Cunningham SC, Napolitano LM. Image of the Month—Quiz Case. Arch Surg. 2007;142(7):685. doi:10.1001/archsurg.142.7.685