0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
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

Austin L. Spitzer, MD; Rita A. Mukhtar, BA; Hobart W. Harris, MD, MPH
[+] Author Affiliations

Author Affiliations: Department of Surgery, University of California, San Francisco (Drs Spitzer, Mukhtar, and Harris); Department of Surgery, University of California, East Bay, Oakland (Dr Spitzer).


Arch Surg. 2005;140(10):1005. doi:10.1001/archsurg.140.10.1005.
Text Size: A A A
Published online

A 32-year-old man was seen in the emergency department after an episode of severe abdominal pain associated with bloating, nausea, and vomiting. The patient reported having no stool or gas for 1 week. He complained of intermittent abdominal pain over the previous 2 to 3 years but denied having any medical or surgical history, including pancreatitis. He did not recall sustaining any injuries.

On examination, his abdomen was mildly distended and he complained of moderate epigastric discomfort. His laboratory results were remarkable for dehydration. A computed tomographic scan was obtained (Figure 1). The patient subsequently underwent exploratory laparotomy after resuscitation without bowel preparation, given his proximal obstruction. The gross pathological specimen is shown in Figure 2.

Place holder to copy figure label and caption
Figure 1.

Computed tomographic scan of the abdomen with oral and intravenous contrast demonstrating a cystic mass associated with the duodenum.

Graphic Jump Location

Place holder to copy figure label and caption
Figure 2.

Photograph of the surgical specimen prior to resection demonstrating focal dilation of the duodenum with the cystic lesion.

Graphic Jump Location

WHAT IS THE DIAGNOSIS?

A. Pancreatic pseudocyst

B. Traumatic intramuscular cyst of the duodenum

C. Duodenal duplication cyst

D. Echinococcal cyst

Figures

Place holder to copy figure label and caption
Figure 1.

Computed tomographic scan of the abdomen with oral and intravenous contrast demonstrating a cystic mass associated with the duodenum.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Photograph of the surgical specimen prior to resection demonstrating focal dilation of the duodenum with the cystic lesion.

Graphic Jump Location

Tables

References

Correspondence

CME
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.
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.
Submit a Comment

Multimedia

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

Related Content

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

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