TY  - JOUR
T1  - IMage of the month—quiz case
AU  - Gordon PE, Miller DL, Rattner DW, Conrad C
Y1  - 2011/04/01
N1  - 10.1001/archsurg.2011.66-a
JO  - Archives of Surgery
SP  - 487
EP  - 487
VL  - 146
IS  - 4
N2  - 
An 83-year-old woman with a noncontributory surgical history presented with nearly 1 month of mild, intermittent right upper quadrant pain. She soon noticed a slowly growing mass in this area. She denied fever, chills, nausea, or a history of trauma. Physical examination revealed a fluctuant, palpable mass in the right upper quadrant with overlying erythema and mild tenderness to palpation (Figure, A). Laboratory values were significant for a white blood cell count of 13.4 million /μL (to convert to × 109/L, multiply by .001). Noncontrast abdominal computed tomography demonstrated a large hiatal hernia, small bilateral pleural effusions, and a right anterior abdominal wall subcutaneous lesion that was approximately 5 × 9 cm. In addition, there were multiple large gallstones within an edematous gallbladder with pericholecystic fat stranding (Figure, B). Surgical management was indicated.

SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2011.66-a
UR  - http://dx.doi.org/10.1001/archsurg.2011.66-a
ER  -