March 25, 2010

Surgery OSCE Quiz 7

64 years old Malay Gentleman who works as a trishaw driver presented with abdominal discomfort for 1/12 which proceeded by spurious diarrhea a week before the onset of abdominal discomfort.

Below, is on section of his CT abdomen image.

1) Comment on the CT scan

2) What other radiology modality that can detect findings that you mention in (1)

3) What is your provisional diagnosis

4) What other investigation you would like to perform to confirm your diagnosis.

5) How do you manage this patient


  1. Assalamualaikum,
    Dr. Naim,
    Ada jawapan utk slide ni tak? Thanks

  2. pneumoperitoneum?

  3. peace be upon all of you..the key is to go back to the history of the patient.. you may just give ur differential diagnosis based on your finding as long it is reasonable.. however, just for the sake of knowledge, i will share the discussion of that case.

    the key here is trishaw driver= low socioeconomic status
    spurious diarrhea= could arise from bowel, or infection causing diarrhea... from the ct scan, something weird pop out at liver... so think what conditionn associated between diarrhea and liver.

    abdominal discomfort= a very generalized presentation..but again correlate with ct finding..

  4. 1)Hypodense at the right lobe of liver with heteroechogenicity

    2) USG

    3) Amoebic liver abscess

    4) FBC, LFT, UFEME, Stool C+S

    5) Percutaneous drainage with ATB

    Pls check my ans. Thx.


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