Clinical presentation
An 82 year old woman presented with a history of intermittent colicky abdominal pain for the past few months. Examination showed a mildly distended abdomen with a 8 cm soft right sided intra‐abdominal mass. She was anaemic with a haemoglobin value of 9 g/dl and her nutritional status was poor, with an albumin level of 14 g/l. She still opened her bowels daily. Computed tomography (CT) of the abdomen with three dimensional coronal view reconstruction was performed (fig 1). Colonoscopy showed no abnormality up to the splenic flexure. Further advancement was forbidden due to acute angulation. Enteral and parental nutritional supplementation failed to improve the clinical condition.
Figure 1 Computed tomography of the abdomen with three dimensional coronal view reconstruction.
Question
What abnormalities does the CT image show? What is the likely diagnosis?
See page 546 for answer
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