TY  - JOUR
T1  - IMage of the month—quiz case
AU  - Costi R, Bataille N, Cazaban A, Montariol T
Y1  - 2009/05/18
N1  - 10.1001/archsurg.2009.64-a
JO  - Archives of Surgery
SP  - 481
EP  - 482
VL  - 144
IS  - 5
N2  - 
An otherwise healthy 68-year-old white man presented with a 4-day history of hyperthermia, a 6/10 dull pain (analogic pain scale) at the right superior abdominal quadrant, and nausea. Physical examination revealed a temperature of 40.1°C and mild right subcostal tenderness without rebound. Laboratory testing showed a perturbation of hepatic enzymes, an alteration of renal function, and an elevated white blood cell count. Ultrasound revealed the presence of gallbladder stones and of a round hypoechogenic image in the fourth hepatic segment 5 cm in diameter; a computed tomographic (CT) scan of the abdomen confirmed the presence of a hypodense image in the liver and revealed the presence of gas in the gallbladder (Figure 1).

SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2009.64-a
UR  - http://dx.doi.org/10.1001/archsurg.2009.64-a
ER  -