Case of the Month: July 2013

Submitted by Louis Muscarella, MD, and Thomas J. Learch, MD .

A 34-year old female presents to the emergency department at 2 am with abdominal pain that has been occurring intermittently for 5 years with associated occasional diarrhea.   The symptoms get worse during periods of stress.   Aside from a feeling of mild pressure with deep palpation of the abdomen, the physical examination is negative.   A CT of the abdomen pelvis is ordered and it was read as negative except for the following findings.  

For a full-size image, please click CT Abdomen 1 .

1- What two conditions are seen in the image above?

A- Metastatic disease
B- HIV infection
C- Old Granulomatous disease
D- Accessory spleen (splenule)
E- Answer choices C and D

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