UMEM Educational Pearls

Title: What's the Diagnosis? Case submitted by Dr. Mak Moayedi

Posted: 9/8/2013 by Haney Mallemat, MD (Updated: 9/9/2013)
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Question

This week's case is challenging, but very interesting...

An elderly patient presents with a history of significant weight loss and chronic constipation; abdominal Xray is below. What's the diagnosis? (Hint: why is the right kidney and psoas muscle so well defined?)

Answer

Massive retroperitoneal and peritoneal free-air from ascending colon rupture; colon cancer was eventually diagnosed in the operating room.
Notice that the kidney and psoas muscle outlined by the free-air below.

References

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