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Special Feature |

Image of the Month—Quiz Case

Antonio D. Lassaletta, MD; Frankie B. Fike, MD; Ketan R. Sheth, MD
JAMA Surg. 2013;148(6):577. doi:10.1001/jamasurg.2013.303a.
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A 61-year-old man, who was a recent immigrant from rural India and a lifelong strict vegetarian, presented to the emergency department complaining of 2 days of diffuse and progressive abdominal pain that did not improve with 400 mg of ibuprofen. Through an interpreter, he reported having had no episodes of emesis and no changes in bowel movements, the last one of which occurred the morning of presentation. His last oral intake, which was also the morning of presentation, consisted of tea and was well tolerated despite worsening abdominal pain. He reported no recent changes in dietary patterns. His medical history was significant only for migraines, for which he took imipramine and carbamazepine.

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Figure 1. Computed tomographic images showing a 5 × 1.8-cm calcification on the left side of the midabdomen with an associated 10-cm phlegmon.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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