Issue: 2018 > March > photo quiz

An unusual cause of chronic abdominal symptoms



PHOTO QUIZ
H.J. Brands, S.J. Lupton, M. van ’t Veer- ten Kate, W.H. de Vos tot Nederveen Cappel
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CASE REPORT

A 78-year-old man presented with a two-month history of abdominal pain, predominantly postprandial, which increased when walking, an altered defecation pattern of loose, black stools, and unintentional weight loss. The patient’s past medical history was significant for gastric carcinoma, for which total gastrectomy with roux-and-y anastomosis had been performed, and for previously reported recurrent abdominal pain, for which an abdominal CT showed only diverticulosis. 
All vital signs were normal. Abdominal examination revealed normal peristaltic sounds, tenderness, guarding and rigidity in the left iliac fossa, and a possible palpable infiltrate. All laboratory results were within normal limits. An abdominal CT scan was repeated.  


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