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Special Feature |

Image of the Month—Quiz Case FREE

Jae Y. Kim, MD; Laura Goetz, MD
[+] Author Affiliations

Author Affiliations:Division of Colorectal Surgery, Department of Surgery, University of California at San Francisco.


Section Editor: Grace S. Rozycki, MD


Arch Surg. 2007;142(1):97. doi:10.1001/archsurg.142.1.97.
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Published online

An 87-year-old woman had acute onset of lower abdominal pain following a painful bowel movement. She had a history of diverticulitis and chronic constipation. Her medical and surgical history also included a remote history of renal cell cancer status after left nephrectomy, a hysterectomy, and steroid-dependent arthritis. On physical examination, she was afebrile and normotensive, but in moderate distress with lower abdominal tenderness and guarding. Abdominal computed tomography was performed (Figure 1and Figure 2).

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Figure 1.

Computed tomographic scan of the abdomen.

Graphic Jump Location

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Figure 2.

Computed tomographic scan of the pelvis.

Graphic Jump Location

WHAT IS THE DIAGNOSIS?

A. Perforated diverticulitis

B. Perforated peptic ulcer

C. Perforated stercoral ulcer

D. Perforated appendicitis

Figures

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Figure 1.

Computed tomographic scan of the abdomen.

Graphic Jump Location
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Figure 2.

Computed tomographic scan of the pelvis.

Graphic Jump Location

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