Article Text


A man with abdominal pain
  1. N Rajesh,
  2. B Sumathi,
  3. K Muthirulandi,
  4. J Randhir,
  5. V Rajalakshmi,
  6. G Muthurangan,
  7. R Surendran,
  8. V Jayanthi
  1. Department of Gastroenterology, Pathology and Cardiothoracic Surgery, Stanley Medical College Hospital, Chennai, India
  1. Correspondence to:
 Dr V Jayanthi
 M 97/5, 30th Cross Street, Besant Nagar, Chennai 90, India;

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Answers on p 743.

A 40 year old man presented with intermittent, dull aching abdominal pain of six months’ duration. His appetite was good; there was mild weight loss. On examination he was moderately nourished; there were no peripheral palpable lymph nodes. Abdominal examination revealed a tense cystic smooth surfaced, non-tender retroperitoneal swelling (20 × 10 cm) in left iliac fossa extending into lumbar and hypogastric region. There was no free fluid in the abdomen. On examination of the chest there was diminished air entry in the left upper zone; his spine was normal. Other system examinations gave normal results.


  1. What does the chest radiograph show (fig 1)?

  2. What are the findings on computed tomography of the chest (fig 2)?

  3. What are the findings on computed tomography of the abdomen (fig 3)?

Figure 1

 Chest radiograph, posteroanterior view.

Figure 2

 Computed tomogram of chest.

Figure 3

 Computed tomogram of abdomen.

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