CLINICAL CHALLENGES AND IMAGES IN GI Unusual Cause of Abdominal Pain Kuo-Hua Lin,1 Chih-Jung Chen,2 and Hsu-Heng Yen3 1
Department of Surgery, 2Department of Pathology, and 3Department of Gastroenterology, Changhua Christian Hospital, Changhua, Taiwan
Question: A 24-yearold man visited our gastroenterology clinic due to intermittent, dull, left upper abdominal pain for 6 months. He had an unremarkable medical history and no history of abdominal trauma or surgery. He denied any weight loss. Physical examination revealed a palpable mass in the left upper abdomen. Laboratory examinations were within normal limits. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) were subsequently performed to clarify the nature of the lesion (Figures A and B). What are the findings of the abdominal CT and what is the diagnosis? Look on page 1609 for the answer and see the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI.
Conflicts of interest The authors disclose no conflicts. © 2014 by the AGA Institute 0016-5085/$36.00 http://dx.doi.org/10.1053/j.gastro.2014.02.053
Gastroenterology 2014;146:1608–1609
CLINICAL CHALLENGES AND IMAGES IN GI Answer to the Clinical Challenges and Images in GI: Image 2 (page 1608): Epidermoid Cyst of the Spleen
Abdominal CT revealed a large, cystic lesion of the spleen with partial calcification of the wall (Figure A, arrow). T2WI MRI revealed a 14-cm, homogeneous, hyperintense, cystic lesion without contrast enhancement. The patient underwent laparoscopic splenectomy for the symptomatic tumor (Figure C). On histologic examination, the splenic cyst was lined by mature squamous cells and walled by fibrotic tissues with inflammation (Figure D). A diagnosis of splenic epidermoid cyst was made. Cystic lesions of the spleen are uncommon.1–3 Acquired splenic cysts are caused by trauma, pancreatitis, parasite infection, or neoplasm. Congenital splenic and epidermoid cysts are rare, comprising
Department of Surgery, 2Department of Pathology, and 3Department of Gastroenterology, Changhua Christian Hospital, Changhua, Taiwan
Question: A 24-yearold man visited our gastroenterology clinic due to intermittent, dull, left upper abdominal pain for 6 months. He had an unremarkable medical history and no history of abdominal trauma or surgery. He denied any weight loss. Physical examination revealed a palpable mass in the left upper abdomen. Laboratory examinations were within normal limits. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) were subsequently performed to clarify the nature of the lesion (Figures A and B). What are the findings of the abdominal CT and what is the diagnosis? Look on page 1609 for the answer and see the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI.
Conflicts of interest The authors disclose no conflicts. © 2014 by the AGA Institute 0016-5085/$36.00 http://dx.doi.org/10.1053/j.gastro.2014.02.053
Gastroenterology 2014;146:1608–1609
CLINICAL CHALLENGES AND IMAGES IN GI Answer to the Clinical Challenges and Images in GI: Image 2 (page 1608): Epidermoid Cyst of the Spleen
Abdominal CT revealed a large, cystic lesion of the spleen with partial calcification of the wall (Figure A, arrow). T2WI MRI revealed a 14-cm, homogeneous, hyperintense, cystic lesion without contrast enhancement. The patient underwent laparoscopic splenectomy for the symptomatic tumor (Figure C). On histologic examination, the splenic cyst was lined by mature squamous cells and walled by fibrotic tissues with inflammation (Figure D). A diagnosis of splenic epidermoid cyst was made. Cystic lesions of the spleen are uncommon.1–3 Acquired splenic cysts are caused by trauma, pancreatitis, parasite infection, or neoplasm. Congenital splenic and epidermoid cysts are rare, comprising
![[Abdominal pain of unusual cause].](/assets/img/hold.png)
