[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.204.200.74. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Citations 0
Special Feature
July 21, 2008

Image of the Month—Quiz Case

Author Affiliations

Author Affiliations:Department of General Surgery, Summa Health System, Akron City Hospital, Akron, Ohio.

 

GRACE S.ROZYCKIMD, MBA

Arch Surg. 2008;143(7):711. doi:10.1001/archsurg.143.7.711

A 52-year-old African American man with lactose intolerance, non–insulin-dependent diabetes mellitus, hypertension, and a virgin abdomen presented with a 6-week history of a 4.5-kg weight loss and a 3-month history of worsening, intermittent, colicky epigastric and periumbilical abdominal pain associated with nausea and vomiting. His pain was most intense postprandially but was relieved by vomiting. He had constipation relieved with laxatives but was passing flatus. A computed tomographic scan of the abdomen revealed a 4.5-cm ileal mass causing a high-grade partial small-bowel obstruction (Figure 1and Figure 2). An exploratory laparotomy revealed a 5-cm mass in the proximal ileum. A 12.5-cm segment of proximal ileum was sent for pathological analysis.

×