An uncommon cause of abdominal pain in a young manBMJ 2018; 360 doi: https://doi.org/10.1136/bmj.j5182 (Published 04 January 2018) Cite this as: BMJ 2018;360:j5182
- Timothy Shao Ern Tan, medical officer,
- Foong Koon Cheah, senior consultant radiologist
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
- Correspondence to T S E Tan
A 38 year old man with a known testicular germ cell tumour presented with acute right sided abdominal pain but no other symptoms. Clinical examination showed positive Murphy’s sign. Laboratory investigations showed leucocytosis of 10.6×109 (reference range 4.0-9.0×109)/L and serum C reactive protein of 59 (0.2-9.1) mg/L. Serum liver enzymes were unremarkable. A computed tomography scan of his abdomen and pelvis was performed (fig 1). What abnormality does this scan show?
A tubular hypodense lesion surrounding a central linear hyperdensity adjacent to the ascending colon with surrounding inflammatory changes, suggestive of epiploic appendagitis …