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Chronic intermittent or steady abdominal pain in adults is commonly encountered and may be due to a large variety of syndromes many of them with no demonstrable anatomical abnormality (irritable bowel syndrome, functional dyspepsia), but some involving occult structural, neoplastic or inflammatory conditions that may present a considerable diagnostic difficulty. We present a patient with a clinical entity that deserves better recognition, first suspected by its typical imaging findings.
A healthy elderly patient presented with several months’ history of diffuse abdominal pain of mild to moderate intensity becoming relentless with time with no associated weight loss, fever or anorexia. Examination, X-rays, laboratory tests, gastroscopy and colonoscopy were normal and no diagnosis was reached over several months.
On admission, abdominal CT revealed lymphadenopathy (up to 3.0×1.5 cm) and …