An 81-year-old woman complained of abdominal bloating, lower abdominal discomfort and no bowel movements for several days. She had had an episode of acute diverticulitis 1 year earlier, and a barium enema had confirmed the presence of severe diverticular disease. Endoscopic retrograde cholangiopancreatography 8 months previously had demonstrated a cholecystoduodenal fistula but no gallstones. She had not undergone any abdominal surgery and had been relatively well for the past 8 months.
Abdominal radiographs were consistent with partial bowel obstruction. Computed tomography of the abdomen (Fig. 1) contributed to the diagnosis.
Can you make the diagnosis?
For the answer and a discussion of the diagnosis see page 152.
Footnotes
Submissions to Radiology for the Surgeon, soft-tissue section, should be sent to the section editor: Dr. Lawrence A. Stein, Department of Radiology, Royal Victoria Hospital, 687 Pine Ave. W, Montréal QC H3A 1A1; lawrence.stein{at}muhc.mcgill.c