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Case of the Week 326



What's the most likely diagnosis?

  • 68 year-old male with abdominal pain and nausea



  1. Bladder perforation
  2. Colonic carcinoma
  3. Appendicitis
  4. Aortic aneurysm
  5. Mesenteric panniculitis

Additional Images - Another axial CT scan of abdomen

 

Additional Images

Enhanced CT scan of the abdomen at level of inferior pole of kidneys


Answer:


5. Mesenteric Panniculitis


More (Click Discussion Tab)


Mesenteric Panniculitis

General Considerations

  • Inflammatory process involving adipose tissue of the mesentery
  • Usually over the age of 50
  • Most cases are idiopathic
  • Recent surgery, especially cholecystectomy and appendectomy apparently predispose to its development
    • Also found more often in those with
      • Cholelithiasis
      • Lymphoma
      • Cirrhosis
      • Abdominal aortic aneurysm
      • Peptic ulcer
      • Gastric carcinoma
      • Prior abdominal trauma
      • Autoimmune disease

More ...


This Week

68 year-old with abdominal pain and nausea undergoes a CT scan of the abdomen
 
Test yourself in the second of a two-part video podcast covering some of the key differential diagnoses in musculoskeletal imaging. This podcast can be used as an audio only, video only or combined audio/video podcast

 

Subscribe to video podcasts from LearningRadiology.com and be notified when new mini-tutorials designed especially for the small screen become available
 
A mobile version for your PDA or internet-enabled smartphone with lists of differential diagnoses, most commons and more
 
An approach to bowel gas patterns, soft tissue masses and abdominal calcifications
 
The top diagnostic images that all medical students should know according to the Alliance of Medical Student Educators in Radiology
 
A pattern-recognition approach to the diagnosis of cardiac disease from frontal chest radiographs
 
Key differential diagnoses in gastrointestinal imaging
 
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LearningRadiology.com is an award-winning educational site aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of case quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, cardiac, and bone radiology.