A woman with tuberous sclerosis and acute onset right sided abdominal pain

doi:10.1136/bmj.b987

Published 24 June 2009, doi:10.1136/bmj.b987
Cite this as: BMJ 2009;338:b987

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A woman with tuberous sclerosis and acute onset right sided abdominal pain

Anu Balan, specialist registrar in radiology, David Kessel, consultant in vascular radiology

¹ Leeds General Infirmary, Leeds LS1 3EX

A Balan balan.anu@gmail.com

The first 150 words of the full text of this article appear below.

A 40 year old woman with a history of tuberous sclerosis presentedto the accident and emergency department with severe, acuteonset right sided abdominal pain. On clinical examination shelooked pale, had poor capillary refill, and was tachycardicand hypotensive. Her abdomen was distended, with bilaterallytender, palpable flank masses. Her haemoglobin measured 8 g/dl.After aggressive resuscitation with intravenous fluids, shewas deemed stable enough to undergo computed tomography, asan intra-abdominal source of acute haemorrhage was suspected.

Figures 1 and 2 are computed tomography images of the mid-abdomenand lower abdomen.