Case of the Month

Our Imaging Case of the Month is presented as a part of the imaging department's residency teaching program. Each month a resident collaborates with one of our attending imaging physicians to present an interesting case to the Cedars-Sinai medical community. The case is used to teach both imaging and other residents at Cedars-Sinai. Below is the current Case of the Month:  

Submitted by Garrett Dejesus, MD, and Thomas J. Learch, MD.

Mrs. J. H.

History of present illness:

68-year-old female presenting to the emergency room with severe lower abdominal pain, nausea and vomiting.  The patient reports a remote history of abdominal surgery for vague abdominal, discomfort.  The surgery found no cause for her pain.  She now reports acutely worsened abdominal pain.

Family history:

Ulcerative colitis (mother)

Physical examination:  

Vital signs within normal limits
Moderately distended abdomen, tender in mid abdomen and left lower quadrant

Laboratory test:

WBC and lactate within normal limits

Question 1:

What diagnostic imaging test should be considered at this point?

A) MRI abdomen/pelvis
B) Abdominal plain film
C) Ultrasound abdomen
D) No imaging required: conservative care     indicated at this time


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