Images in Clinical Medicine

Medical Mystery — Abnormal Abdominal Radiograph

Kumiko Tajima, M.D., Ph.D., and Masahiko Kurabayashi, M.D., Ph.D.

N Engl J Med 2006; 355:2467December 7, 2006

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A 50-year-old woman presented to the emergency department with obtundation and hypotension. She had a 1-month history of slight fever, before which she had been well. On abdominal examination, an immobile, tender, firm mass was palpated to the right of the umbilicus. Laboratory evaluation revealed a white-cell count of 17,200 per cubic millimeter, a serum glucose level of 607 mg per deciliter (33.7 mmol per liter), a blood urea nitrogen level of 70 mg per deciliter (25.0 mmol per liter), and a serum creatinine level of 4.0 mg per deciliter (354 μmol per liter). An abdominal radiograph was obtained. What is the diagnosis?

Kumiko Tajima, M.D., Ph.D.
Masahiko Kurabayashi, M.D., Ph.D.
Gunma University Graduate School of Medicine, Gunma 371-8511, Japan
mkuraba@med.gunma-u.ac.jp

Citing Articles (1)

Citing Articles

1. 1

   Kurabayashi, Masahiko, Tajima, Kumiko, . (2007) Medical Mystery: Abnormal Abdominal Radiograph — The Answer. New England Journal of Medicine 356:5, 526-527
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