title: Soft tissue case 61.
abstract: A 55-year-old man presented to the emergency department with a 12-hour history of severe crampy abdominal pain, nausea, vomiting and obstipation. The patient had a complex medical history, including coronary artery disease, lupus, hypothyroidism, epilepsy, pancreatitis and renal calculi. However, the patient had no history of a hernia or abdominal surgery. Physical examination revealed a temperature of 38.5 degrees C and a soft distended abdomen that was diffusely tender without signs of peritonitis. The rest of the physical examination was unremarkable. Routine laboratory investigations including a complete blood cell count, electrolytes, liver enzymes and amylase were normal, with the exception of a decreased hemoglobin level of 116 g/L. We ordered a plain abdominal radiograph (Fig. 1) and a contrast-enhanced computed tomography (CT) scan of his abdomen. What is your diagnosis?
authors.affiliation: University of British Columbia and the.
authors.forename: Lisa
authors.initials: L
authors.lastname: Aird
authors.forename: Pari
authors.initials: P
authors.lastname: Tiwari
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Brown
references.citation: Ann Surg. 1992 Aug;216(2):135-41
references.pmid: 1503517
references.citation: Can Assoc Radiol J. 2004 Dec;55(5):297-303
references.pmid: 15646457
references.citation: J Gastroenterol Hepatol. 2005 Dec;20(12):1906-12
references.pmid: 16336452
references.citation: J Am Coll Surg. 2008 Apr;206(4):658-63
references.pmid: 18387471
references.citation: J Am Coll Surg. 2004 Oct;199(4):628-35
references.pmid: 15454150