DOI: 10.1148/radiol.2233010373
(Radiology 2002;223:765-766.)
© RSNA, 2002
Case 511
Ross L. Titton, MD and
Fergus V. Coakley, MD
1 From the Department of Radiology, Memorial Sloan-Kettering Cancer Center. Received January 29, 2001; revision requested March 6; revision received March 21; accepted April 3. Address correspondence to F.V.C., University of California, San Francisco, Box 0628, Rm M-372, 505 Parnassus Ave, San Francisco, CA 94143-0628 (e-mail: Fergus.Coakley@radiology.ucsf.edu).
Index terms: Diagnosis Please
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HISTORY
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A 32-year-old woman presented to the emergency department with a 3-day history of epigastric pain, vomiting, increasing pallor, and dark urine. Her medical history disclosed no abnormal findings. Physical examination revealed mild jaundice, abdominal distention, and bilateral lower extremity edema. Laboratory studies disclosed anemia, with a hemoglobin level of 70 g/L (7.0 g/dL), where the normal range is 115–160 g/L (11.5–16 g/dL). Hyperbilirubinemia was also disclosed, with a total serum bilirubin level of 75.2 µmol/L (4.4 mg/dL), where the normal range is 0–17.1 µmol/L (0–1.0 mg/dL). Liver enzyme levels were elevated, with an alanine aminotransferase, or ALT, level of 51 U/L (normal range, 5–37 U/L) and an aspartate aminotransferase, or AST, level of 170 U/L (normal range, 10–37 U/L). Serum creatinine level was normal. Findings at abdominal radiography showed a small amount of bowel gas but disclosed no other abnormalities. Abdominal ultrasonography (US) (Fig 1), contrast material–enhanced computed tomography (CT) (Fig 2), and contrast-enhanced magnetic resonance (MR) imaging (Fig 3) were performed, in that order.
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FOOTNOTES
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E-mail the most likely diagnosis to dxplease@rsna.org (use only for submission of diagnosis). Include case number, your name (as you would want it to appear in the journal), address, phone and fax numbers. Only one case, one name, and one diagnosis per e-mail submission. Multiple diagnoses, multiple submissions, submissions without a case number will not be considered. Deadline: August 15. Answer will appear in the October issue. Authors wishing to submit cases for Diagnosis Please should first write to the Editor to obtain approval for the case and further information.
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