華山論劍-專業案例挑戰/Case 2015-005

Date: 30 Sep. posted by 陳子皓/戴啟明/王文倫/張吉仰醫師學術天地

28-year-old female with intermittent abdominal pain for 1 month

One 28-year-old female presented to our clinic for intermittent abdominal pain for one month. She has no significant past medical/surgical history. Her pain, localized mainly at RLQ, had an insidious onset and was characterized as dull ache. The pain did not radiate, and there were no notable aggravating or reliving factors. Besides, she also got bowel habit change, once every three days, with loose stool passage. She denied anorexia, nausea/vomiting, bloody stool passage.

For acute pain exacerbation, she was admitted for further survey. At ER, her vital signs showed low grade fever. On physically, right lower quadrant abdominal tenderness without guarding or rebounding pain was noted. Blood tests revealed microcytic anemia. KUB didn’t reveal significant finding. Abdominal CT disclosed suspicious target-like lesion located at RLQ and multiple lymphadenopathies at perigastric region and retroperitoneum. Colonoscopy was also arranged for further survey.

CBC

KUB

Abdominal CT

Target-like lesion at RLQ (Left arrow)

Lymphadenopathy at perigastric region (Right arrow)

Colonoscopy (Video)

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