Case 205

Abstract

HomeRadiologyVol. 270, No. 1 PreviousNext Diagnosis PleaseFree AccessCase 205Lois S. MacDonald , Gill Rumsby, Snehal LapsiaLois S. MacDonald , Gill Rumsby, Snehal LapsiaAuthor AffiliationsFrom the Department of Radiology, Royal Blackburn Hospital, Haslingden Rd, Blackburn, Lancashire BB2 3HH, England (L.S.M., S.L.); and Department of Clinical Biochemistry, University College London Hospitals, London, England (G.R.).Address correspondence to L.S.M (e-mail: [email protected]).Lois S. MacDonald Gill RumsbySnehal LapsiaPublished Online:Jan 1 2014https://doi.org/10.1148/radiol.13120635MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked InEmail 2014 Diagnosis Please Learning ObjectivesIn submitting a diagnosis for this case, participants demonstrate the ability to■ Recognize normal and abnormal findings as presented in the diagnostic images■ Identify pathologic conditions indicated in the diagnostic images■ Use clinical reasoning skills to generate a list of differential diagnosesAccreditation and Designation StatementThe RSNA is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The RSNA designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Disclosure StatementThe ACCME requires that the RSNA, as an accredited provider of CME, obtain signed disclosure statements from authors, editors, and reviewers for this case. For this educational activity the authors, editors, and reviewers have indicated that they have no relevant relationships to disclose.Submit Diagnosis Submit the most likely diagnosis to http://rsna.org/dxplease (use only for submission of diagnosis). Select the case from the Active Case List for which you are submitting a diagnosis. Only one case, one name, and one diagnosis per e-mail submission. Multiple diagnoses and multiple submissions will not be considered. Deadline: Midnight U.S. Central Time, March 10, 2014. Answer will appear in the May 2014 issue. Authors wishing to submit cases for Diagnosis Please should first write to the Editor to obtain approval for the case and further information.HistoryAn 80-year-old woman presented to the on-call surgical team with a 2-day history of abdominal distention and vomiting. Clinical examination revealed a distended tympanic abdomen with generalized tenderness but no evidence of peritoneal signs at physical examination. Relevant surgical history included previous intervention for renal stones, cholecystectomy, and cardiovascular and respiratory comorbidities. Abdominal radiography was performed in the emergency department, and computed tomography (CT) was performed based on the radiographic findings (Figs 1–3).Figure 1: Supine abdominal radiograph.Figure 1:Download as PowerPointOpen in Image Viewer Figure 2a: (a–d) Contrast material–enhanced (100 mL iohexol, Omnipaque 350; Nycomed Amersham, Oslo, Norway) axial CT images in the portal venous phase.Figure 2a:Download as PowerPointOpen in Image Viewer Figure 2b: (a–d) Contrast material–enhanced (100 mL iohexol, Omnipaque 350; Nycomed Amersham, Oslo, Norway) axial CT images in the portal venous phase.Figure 2b:Download as PowerPointOpen in Image Viewer Figure 2c: (a–d) Contrast material–enhanced (100 mL iohexol, Omnipaque 350; Nycomed Amersham, Oslo, Norway) axial CT images in the portal venous phase.Figure 2c:Download as PowerPointOpen in Image Viewer Figure 2d: (a–d) Contrast material–enhanced (100 mL iohexol, Omnipaque 350; Nycomed Amersham, Oslo, Norway) axial CT images in the portal venous phase.Figure 2d:Download as PowerPointOpen in Image Viewer Figure 3a: (a, b) Coronal reformatted contrast-enhanced CT images in the portal venous phase.Figure 3a:Download as PowerPointOpen in Image Viewer Figure 3b: (a, b) Coronal reformatted contrast-enhanced CT images in the portal venous phase.Figure 3b:Download as PowerPointOpen in Image Viewer Article HistoryPublished online: Jan 2014Published in print: Jan 2014 FiguresReferencesRelatedDetailsCited ByBritish Journal of Hospital Medicine, Vol. 81, No. 8Recommended Articles Case 282Radiology2020Volume: 295Issue: 3pp. 733-735Case 268Radiology2019Volume: 291Issue: 1pp. 259-260Case 245Radiology2017Volume: 283Issue: 2pp. 609-612Case 269Radiology2019Volume: 291Issue: 2pp. 539-541Case 273Radiology2019Volume: 292Issue: 3pp. 773-775See More RSNA Education Exhibits "Rolling Stones in Flank Pain": Update, Management, and ComplicationsDigital Posters2019Percutaneous Endoscopic Retrieval of Dropped Intraperitoneal Stones: A Minimally Invasive Alternative to Open LaparotomyDigital Posters2018Nephrolithiasis Imaging with DECT in the Current Era: Hope or Hype? 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