Volume 86 - 2023 - Fasc.1 - Clinical images
A 43-year-old male with acute right upper quadrant pain and skin rash
A 43-year-old male presented with acute right upper
quadrant pain, nausea, and itchy skin rash for two hours.
Physical examination revealed abdominal tenderness and
itchy abdominal skin lesions that are compatible with
urticaria. The patient’s blood pressure was 95/55 mmHg,
pulse rate was 122 beats/minute, body temperature was
37.1 C degrees, and partial oxygen saturation was 96%
in the room air. He had no history of recent trauma or
chronic disease. Laboratory test results were within
normal limits except for increased white blood cell count
(14.79 K/uL, reference range; 4-10 K/uL). Abdominal
ultrasound (US) was performed, and the US revealed
abdominal free fluid and a thin-walled lobulated cystic
lesion in the liver dome. For further evaluation, contrastenhanced
abdominal computed tomography (CT) was
obtained. CT showed a thin-walled cystic lesion with
lobulated contours in the liver, pericystic fat stranding,
perihepatic free fluid, and right pleural effusion (Figure
1).
A case of duodenal malignancy or something else?
A 63-year-old man was hospitalized with abdominal
pain and vomiting. Abdominal CT described gastric
distention, identifying an abrupt decrease in caliber in the
second portion of the duodenum (Fig.1A).
Upper endoscopy revealed, in the transition from the
bulb to the second duodenal portion, an edematous and
diffusely congestive mucosa causing obstruction, not
allowing passage of the gastroscope.
