Immunoglobulin G4-Related Disease Mimicking Malignant Bowel Obstruction

Abstract

A 40-year-old man with ankylosing spondylitis and left buccal cancer presented to our emergency department with periumbilical pain, nausea, and abdominal distention for 3 days. He denied undergoing abdominal surgery. His vital signs were normal. Physical examination showed a distended abdomen with periumbilical tenderness. Routine blood testing showed mild neutrophilic leukocytosis (white blood cell count, 10,400/μL; neutrophils, 82%). Computed tomography imaging showed a mass-forming lesion involving the ileocecal valve (Figure A, arrow).