Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Feature |

Image of the Month—Quiz Case FREE

Steven C. Cunningham, MD; Lena M. Napolitano, MD
[+] Author Affiliations

Author Affiliations:Department of Surgery, University of Maryland Medical Center, and Department of Surgery, Veterans Affairs Maryland Healthcare System, Baltimore. Dr Napolitano is now with the Department of Surgery, University of Michigan Health System, Ann Arbor.

Section Editor: Grace S. Rozycki, MD

Arch Surg. 2007;142(7):685. doi:10.1001/archsurg.142.7.685.
Text Size: A A A
Published online

A 37-year-old man with Crohn disease, quiescent since an ileal resection and end ileostomy followed by elective ileostomy closure 10 years ago, came to the emergency department with a 2-month history of crampy abdominal pain in both lower quadrants associated with a weight loss of 11 kg, fevers and chills, mild nausea and vomiting, and diarrhea following a recent trip to Mexico. On examination, he had a palpable 5 × 7-cm mass in the right lower quadrant. Computed tomographic evaluation of the abdomen was performed (Figure).

Place holder to copy figure label and caption

Computed tomographic scan of the abdomen.

Graphic Jump Location


A. Double intussusceptions of the descending colon

B. Enterorectus fistula

C. Gastrointestinal stromal tumor of the intestine

D. Duplication cyst of the small intestine


Place holder to copy figure label and caption

Computed tomographic scan of the abdomen.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
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.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles