TY - JOUR T1 - IMage of the month—quiz case AU - Adachi K, Yokoro S Y1 - 2012/03/01 N1 - 10.1001/archsurg.2011.709a JO - Archives of Surgery SP - 293 EP - 293 VL - 147 IS - 3 N2 - A previously healthy 14-year-old boy visited our hospital with epigastric pain, abdominal distention, nausea, and vomiting after a large meal. He denied fever or lymphadenopathy. His medical history was unremarkable. Physical examination disclosed moderate abdominal distention and minimal epigastric tenderness. The results of relevant laboratory tests were within normal ranges. A plain radiograph of the abdomen demonstrated a dilated small bowel in the upper abdomen without pneumoperitoneum. Subsequently, coronal imaging on an abdominal computed tomographic (CT) scan was obtained (Figure 1). On the basis of our findings, he underwent emergency laparotomy (Figure 2). SN - 0004-0010 M3 - doi: 10.1001/archsurg.2011.709a UR - http://dx.doi.org/10.1001/archsurg.2011.709a ER -