Case 71

 Case 1. A sixty three-year-old female came to our hospital suffering from epigastric pain and right-sided abdominal pain. She experienced diarrhea several times in the morning. Her body temperature was 38 centigrade. Four days ago, she ate pieces of raw cow liver and Sushi. Abdominal palpation revealed tenderness of upper and right-sided abdomen. Laboratory test revealed white blood cells of 10900 /mm³ neutrophils 88.1%, CRP 0.16 mg/dL. Abdominal CT was conducted for further investigation (Fig. 1)

 Case 2. A sixty four-year-old female presented suffering from bloody diarrhea. She was a friend of the Case 1 patient and ate raw cow liver at the same restaurant five days ago. She got some medicine in a local clinic which induced improvement of abdominal pain but persistent diarrhea continued. She came to our hospital because she knew her friend was admitted to our hospital. Laboratory test revealed white blood cells of 20460 /mm³ neutrophils 80.6%, CRP 7.59 mg/dL. Abdominal CT was conducted to investigate what happened (Fig. 2)

What is the imaging diagnosis on abdomen of both patients ?

1. Ulcerative colitis

2. Anisakiasis

3. Crohn disease

4. Escherichia coli 0157

5. Ischemic colitis

answer

2017.9.13