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Quizzes and Polls

Latest Quiz

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November 2014

The Cocoon Abdomen

An 85-year-old man with a history of occupational exposure to asbestos presented with 1 week of nausea and vomiting without any bowel function. He reported only mild abdominal pain.

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Test your knowledge with previous versions of the JAMA Surgery Image of the Month Quiz.

November 2014

Bleeding Abdominal Mass in a Patient With Genetic Cutaneous Disorder

A 72-year-old man presented to the hospital after sustaining a fall, with prior generalized weakness and fatigue. He had been having recurrent gastrointestinal bleeding and melena during the past year.

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October 2014

Firm Flank Mass Decreasing in Size After Pregnancy

A woman in her mid-30s pregnant with twins at 13 weeks' gestation presented with a tender right-flank mass, which she noticed after falling and sustaining trauma to the area 1 week previously.

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October 2014

Pancreatic Neoplasm With Metastatic Workup

A previously healthy 75-year-old woman was referred to our tertiary care center when a workup for abdominal pain and jaundice revealed a duodenal mass.

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September 2014

An Unusual Hernia

A 68-year-old woman presented 1 year after noticing a flank bulge that developed following a forceful coughing episode. Her medical history included gastroesophageal reflux disease, irritable bowel syndrome, hypothyroidism, hypertension, asthma, and obesity.

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September 2014

Abrupt Vomiting and Pain With Abdominal Mass

A 90-year-old woman presented with vomiting and acute abdominal pain that started 24 hours earlier. Her medical history included a partial oophorectomy of a right ovarian cyst, hypertension, and vomiting and abdominal pain once a year that started 10 years earlier.

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September 2014

Indeterminate Left-Sided Retroperitoneal Mass

A woman in her 30s with a history of chronic hepatitis B was found on computed tomography to have a 13-cm retroperitoneal mass on her left side with a significant mass effect.

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August 2014

Young Woman With Massive Splenomegaly

An otherwise healthy woman in her early 20s was referred to our general surgery clinic for massive splenomegaly after developing a migratory, urticaric maculopapular rash over her body earlier in the year.

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August 2014

Unpredictable Location of Central Catheter

A man in his mid-50s presented to the hospital with malaise, fevers, hypotension, and altered mental status. Three months prior, he had an episode of native aortic valve endocarditis, necessitating aortic valve replacement with a pericardial bioprosthesis.

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July 2014

Lower Abdominal Pain With Nausea and Vomiting

A woman in her 40s presented to our department with lower abdominal pain, lasting for a few weeks, with nausea and vomiting but no diarrhea or fever. Her medical history was unremarkable; in particular, she had no history of endometriosis.

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July 2014

Pelvic Mass After Prostatectomy

A 66-year-old man was doing well 6 months after robotic radical prostatectomy for prostatic carcinoma and synchronous left radical nephrectomy for renal cell carcinoma.

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July 2014

Abdominal Wall Mass

A man in his 60s presented to the emergency department with a right flank mass that had been present for 4 weeks. The mass was associated with increasing pain as it grew rapidly, starting from the size of a dime and increasing to extend 15 cm.

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June 2014

Abdominal Pain and Mass

A 28-year-old man presented with several months of constant, burning upper abdominal pain centered on the epigastrium. The pain was associated with morning nausea and was worsened by food and alcohol.

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June 2014

Traumatic Hemoperitoneum

A 33-year-old woman presented to the emergency department as a restrained driver in a motor vehicle collision with air bag deployment. The patient had diffuse lower abdominal pain with nausea and one episode of emesis.

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June 2014

Rare Cause of Recurrent Small-Bowel Obstruction

A 34-year-old female Jehovah's Witness presented to the emergency department with a 3-day history of colicky lower abdominal pain, nausea without vomiting, and constipation after passing a single small bloody bowel movement.

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May 2014

Man With Nausea and Fever

A 52-year-old man presented with a 2-day history of nausea and low-grade fever to a local hospital. He had a history of simultaneous pancreas-kidney transplantation 15 years ago and both grafts had been functioning well.

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May 2014

Right Lower Quadrant Pain During Pregnancy

A 26-year-old woman in the 11th week of gestation with a history of nephrolithiasis was admitted to our medical center reporting of right lower quadrant pain, loss of appetite, nausea, and vomiting occurring over 5 days.

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April 2014

Traumatic Hemoperitoneum

A 33-year-old woman presented to the emergency department as a restrained driver in a motor vehicle collision with air bag deployment. The patient had diffuse lower abdominal pain with nausea and one episode of emesis.

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April 2014

Man With Hypoechoic Lesion Abutting the Pancreas

A previously healthy, 37-year-old man presented for a routine physical examination during which a pulsatile mass in his midepigastrium was palpated. Abdominal ultrasonography showed a well-defined hypoechoic lesion abutting the pancreas.

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March 2014

Complex Cystic Lesions in the Liver Causing Abdominal Pain

A 74-year-old woman was seen by her primary care physician for dull epigastric and right upper quadrant abdominal pain of 1-year duration. Routine laboratory values were within normal limits.

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March 2014

Enlarging Breast Mass in a 55-Year-Old Woman

A 55-year-old woman presented to the clinic with a mass in her left breast that had been enlarging over the previous 3 months. The patient denied any antecedent trauma or infection.

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February 2014

An Uncommon Surgical Disease

A woman in her 50s was hospitalized for a painful anal mass. She had a history of hypertension and depression and was receiving omeprazole and paroxetine.

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February 2014

Diffuse Ulcerated Skin Rash

A 66-year-old man presented with a skin rash on his lower limb. He has been unemployed and bedridden for the last 3 years owing to his skin disease.

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February 2014

Progressive Soft-Tissue Necrosis

A 52-year-old man with type 2 diabetes mellitus and end-stage renal disease presented with painful and progressive cutaneous necrosis of his fingers, toes, and calves and generalized muscle weakness with difficulty getting out of bed and walking.

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January 2014

Left Lower Quadrant Mass

An 88-year-old man with a history of hypertension, atrial fibrillation while receiving warfarin sodium, congestive heart failure, extended right hemicolectomy for colon cancer, and abdominal aortic aneurysm repair visited the hospital with epigastric pain of 3 days' duration.

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January 2014

Pulmonary Air Crescent Sign

A 62-year-old man was admitted to our hospital with a concern of productive cough, profuse hemoptysis, and intermittent breathlessness for about 5 months. He had a 60-year history of cigarette smoking and had stopped smoking 5 months prior to being seen.

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December 2013

Right Iliac Fossa Pain

A 32-year-old woman presented to the hospital complaining about having colicky abdominal pain for the last 2 weeks. The pain was usually generalized but sometimes radiated to the right iliac fossa.

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December 2013

Abdominal Pain and a Biliary Abnormality

A 30-year-old female immigrant from Laos was referred to our institution after admission to an outside hospital for right upper quadrant abdominal pain with associated nausea and vomiting.

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November 2013

A Well-Circumscribed, Painless Abdominal Mass

A 28-year-old woman presented with a complaint of a painless abdominal mass that had been increasing in size during the past few years. Several different physicians had evaluated the patient previously without a definitive diagnosis or treatment.

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October 2013

Right Lower Quadrant Pain

A 50-year-old man presented to the emergency department with a 4-day history of right lower quadrant pain that did not migrate during that period of time.

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September 2013

Gallbladder Disease in an Elderly Patient

An 89-year-old woman presented to her geriatrician with abdominal pain for 2 days. The pain was localized to her right abdomen, both upper and lower quadrants, with acute tenderness to palpation.

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August 2013

An Unexpected Find

A 64-year-old woman presented to the emergency department with a 1-day temperature of 38.9°C (102°F). The patient had some accompanying cough, nausea, and arthralgias but denied having dyspnea, emesis, and chest or abdominal pain.

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July 2013

An Unusual Inflammatory Hepatic Lesion

A 26-year-old man was admitted to our institution for a fever (temperature, 39°C) and abdominal pain on the right side of his hypochondrium.

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June 2013

A 50-year-old white man presented to the emergency department with a chief complaint of worsening right inguinal pain and swelling for 3 days. He denied any past medical or surgical history.

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May 2013

A 33-year-old man visited the hospital with marked abdominal distention and vomiting. His medical history included epilepsy and mild mental retardation.

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April 2013

A 62-year-old woman with a medical history of gastroesophageal reflux disease, hypothyroidism, and remote bronchial tuberculosis presented to the emergency department with acute-onset bright red blood per rectum.

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March 2013

A 21-year-old man presented to the emergency department after gunshot wound to the right shoulder.

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February 2013

A 68-year-old woman with hepatocellular carcinoma underwent a liver transplant.

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January 2013

A 67-year-old female patient was referred to our hospital because of a 1-year history of intermittent right upper quadrant pain associated with anorexia and weight loss (5 kg in 6 months).

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December 2012

A 54-year-old man with a history of chronic alcoholic pancreatitis and hepatitis presented with epigastric pain and melena, with a loss of 6 kg of body weight during the last month.

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November 2012

An 18-year-old man had a 3-month history of worsening diffuse abdominal pain irradiating to the back, abdominal distention, malaise, weight loss (10 kg), and diarrhea.

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October 2012

A 71-year-old Asian man with a history of cadaveric orthotopic liver transplant for hepatocellular carcinoma in the background of hepatitis B cirrhosis 10 years earlier presented with a 6-month history of decreased appetite, decreased energy level, and slowly increasing α1-fetoprotein level.

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September 2012

A 53-year-old woman had abdominal pain, nausea, vomiting, and obstipation for 4 days.

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August 2012

A 52-year-old man came to the clinic with occasional dysuria, urinary frequency, and nonspecific abdominal pain lasting 5 months.

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July 2012

An 88-year-old woman presented to the emergency department with a 2-day history of gradual-onset, increasing right upper quadrant pain with aggravation on movement and cough.

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June 2012

A 63-year-old man underwent splenectomy, partial wedge resection of the stomach, distal pancreatectomy, and repair of a small diaphragmatic laceration for non-Hodgkin B-cell lymphoma of the spleen.

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May 2012

A 30-year-old woman presented to our clinic with a painless, left-sided neck mass, which had slowly grown during 3 years.

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April 2012

A 76-year-old man with a 2-year history of chronic intermittent epigastric pain was afebrile and had a few episodes of nausea and vomiting.

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March 2012

A 63-year-old man with history of diabetes mellitus and liver transplantation 2 years prior to admission visited the hospital with severe abdominal pain, jaundice, and vomiting 2 days after endoscopic retrograde cholangiopancreatography for investigation of increasingly abnormal liver function test results.

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February 2012

A 71-year-old woman had a sudden onset of what she described as a "tummy ache" at 9 PM the evening prior to admission to the hospital.

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January 2012

A 64-year-old man was referred to our institution after he was found to have a retrorectal mass on a computed tomographic scan he underwent for persistent rectal pain and discomfort.

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December 2011

A 52-year-old man presented to the emergency department with a history of acute left lower quadrant pain.

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November 2011

A 56-year-old woman was referred for evaluation of a multinodular goiter.

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October 2011

A 46-year-old restrained male driver involved in a high-speed head-on collision presented with hemodynamic instability following prehospital intubation for hypoxia.

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September 2011

A 75-year-old man presented to the emergency department with 2 days of sudden-onset abdominal pain, nausea, and 1 episode of hematemesis.

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