Diagn Interv Imaging. 2013 Nov;94(11):1169-74. doi: 10.1016/j.diii.2013.04.005. Epub 2013 May 30.
Klotz T, Da Ines D, Petitcolin V, Lannareix V, Essamet W, Garcier JM.
Ms. K., a 37-year-old patient, consulted the emergency ward for abdominal pain predominantly in the hypochondrium and right iliac fossa. This patient presented a past history of anal sphincter plasty for incontinence following a traumatic childbirth. The clinical examination found a fever at 38.8 °C and diffuse abdominal pain. The lab tests upon admission detected an inflammatory syndrome (leukocytes: 18,000/mm3 and CRP: 150 mg/l) without cytolysis or cholestasis. The urine strip was negative. In view of the intensity of the pain, an abdominal-pelvic CT-scan with injection was carried out to search for acute appendicitis or acute cholecystitis. Acute cholecystitis was diagnosed in view of the distension and vesicular parietal thickening. By chance, a tumour of the tip of the cauda pancreatis was discovered and a complementary assessment by MRI was carried out .