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Chronic diarrhea in a 64-year-old woman

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Our patient presented with abdominal pain and worsening diarrhea. She had no significant medical history, but imaging studies helped us make the Dx.


 

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A 64-year-old woman with no significant medical history presented to the emergency department with worsening intermittent abdominal pain and chronic diarrhea, which had increased in frequency over the prior 3 months. She had taken loperamide, which yielded mild symptomatic relief. A complete metabolic panel revealed no significant abnormalities, with a normal inflammatory marker and erythrocyte sedimentation rate (ESR).

Physical examination revealed mild tenderness to palpation over the right hemiabdomen, but no rebound tenderness or guarding. An abdominal radiograph (FIGURE 1), computed tomography (CT) without contrast of the abdomen and pelvis (FIGURE 2), and a whole-body octreotide scan (FIGURE 3) were ordered.

Chronic diarrhea in a 64-year-old woman

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HOW WOULD YOU TREAT THIS PATIENT?

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