Metastatic carcinoma in the liver simulating the acute surgical abdomen. Report of three cases.

Abstract

Fever, leukocytosis, and right upper quadrant pain is a common symptom complex seen on every Surgical Service. However, intra-abdominal carcinoma with liver metastases is not usually found as a cause for, or in association with, the above clinical traid. Recently we had three patients on our Surgical Service, each presenting with symptoms of a right upper quadrant inflammatory lesion. At emergency laparotomy all three patients were found to have diffuse liver metastases from an unsuspected intraabdominal carcinoma. Report of Cases Case 1. —Two months prior to admission, this 26-year-old white man experienced sudden onset of constant dull pain in his right upper quadrant and at McBurney's point. The pain disappeared slowly over a three-week period, only to recur again one week later, lasting again for three weeks and subsiding. At the time of admission to the hospital, the patient had an exacerbation of the right upper quadrant pain with tenderness,