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Image of the Month—Quiz Case

Image of the Month—Quiz Case A 14-year-old girl had a history of constipation and epilepsy with irregular anticonvulsant drug control since age 9 years. She had dull abdominal pain in the left lower quadrant that was relieved by bending forward and was aggravated in the supine position. This pain developed 7 days before she came to the emergency department. She also had poor appetite and was passing only small amounts of stool. The pain became colic, accompanied by nausea and vomiting, 1 day before she came to the emergency department. Physical examination revealed tenderness in the left lower quadrant and hyperactive bowel sounds. An abdominal radiograph and an abdominal computed tomographic scan are shown in Figure 1. Figure 1. View LargeDownload The abdominal radiograph shows a large filling defect in the stomach, outlined by the water-soluble contrast medium (arrows). Inset, The reformatted coronal computed tomographic scan reveals the bowel obstruction with large fecal material–like masses impacted in the stomach (asterisk) and small bowel (arrow). What Is the Diagnosis? A. Constipation B. Bezoars C. Intussusception D. Volvulus Answer http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Image of the Month—Quiz Case

Abstract

A 14-year-old girl had a history of constipation and epilepsy with irregular anticonvulsant drug control since age 9 years. She had dull abdominal pain in the left lower quadrant that was relieved by bending forward and was aggravated in the supine position. This pain developed 7 days before she came to the emergency department. She also had poor appetite and was passing only small amounts of stool. The pain became colic, accompanied by nausea and vomiting, 1 day before she came to the...
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Publisher
American Medical Association
Copyright
Copyright © 2008 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.143.10.1019
Publisher site
See Article on Publisher Site

Abstract

A 14-year-old girl had a history of constipation and epilepsy with irregular anticonvulsant drug control since age 9 years. She had dull abdominal pain in the left lower quadrant that was relieved by bending forward and was aggravated in the supine position. This pain developed 7 days before she came to the emergency department. She also had poor appetite and was passing only small amounts of stool. The pain became colic, accompanied by nausea and vomiting, 1 day before she came to the emergency department. Physical examination revealed tenderness in the left lower quadrant and hyperactive bowel sounds. An abdominal radiograph and an abdominal computed tomographic scan are shown in Figure 1. Figure 1. View LargeDownload The abdominal radiograph shows a large filling defect in the stomach, outlined by the water-soluble contrast medium (arrows). Inset, The reformatted coronal computed tomographic scan reveals the bowel obstruction with large fecal material–like masses impacted in the stomach (asterisk) and small bowel (arrow). What Is the Diagnosis? A. Constipation B. Bezoars C. Intussusception D. Volvulus Answer

Journal

Archives of SurgeryAmerican Medical Association

Published: Oct 20, 2008

Keywords: anticonvulsants,abdominal pain,epilepsy,contrast media,acute abdominal pain,physical examination,constipation,bezoars,intussusception,pain,abdominal radiography,intestinal obstruction,abdomen,nausea and vomiting,intestinal volvulus,hyperactive bowel sounds,filling defect,stomach,appetite or desire,feces,intestine, small,desire for food,supine position,emergency service, hospital

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