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Special Feature |

Image of the Month—Quiz Case FREE

Shawn D. St Peter, MD; Kevin O. Leslie, MD; Jacques P. Heppell, MD
[+] Author Affiliations

Section Editor: Grace S. Rozycki, MD
From the Departments of Surgery (Drs St Peter and Heppell) and Pathology (Dr Leslie), Mayo Clinic, Scottsdale, Ariz.

Arch Surg. 2004;139(5):565-566. doi:10.1001/archsurg.139.5.565.
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A 77-year-old man presented after 3 days of diffuse abdominal pain, anorexia, and nausea. Four years before admission, he underwent an abdominoperineal resection for rectal cancer and was since admitted twice with episodes of partial small-bowel obstruction that resolved with conservative measures. Recently, he had developed and was treated for a urinary tract infection. In addition to his abdominal pain, he had profuse, watery stomal output. Although he wasafebrile, his white blood cell count was 50.7 ×103/µL. His abdomen was diffusely tender to deep palpation, but he exhibited no guarding or peritoneal signs. A computed tomographic scan of the abdomen showed a diffusely edematous bowel with ascites (Figure 1) and portal venous air (Figure 2).


A.Acute mesenteric venous thrombosis

B.Ischemic colitis

C.Pseudomembranous enterocolitis

D.Inflammatory bowel disease




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