ABSTRACT
An elderly man presented to the emergency department with symptoms of a left-sided weakness. A CT of the brain scan showed an abnormality, and he was diagnosed with a stroke and admitted to the stroke unit. The stroke consultant reviewed him the next morning; a detailed history was acquired and imaging reviewed. As a result of the history of neurological symptoms, a diagnosis of malignancy was suspected and an MRI of the brain was ordered. This did not show a stroke but suggested a mass lesion. A CT of the chest, abdomen and pelvis was ordered to rule out a primary cause. Unfortunately, this showed widespread metastatic carcinoma with a left upper lobe primary (T4 N3 M1b). This was confirmed on histology. The patient died soon after the diagnosis.
Subject(s)
Adenocarcinoma/complications , Brain Neoplasms/complications , Lung Neoplasms/complications , Stroke/etiology , Adenocarcinoma/diagnosis , Adenocarcinoma/secondary , Aged , Brain/diagnostic imaging , Brain/pathology , Brain Neoplasms/diagnosis , Brain Neoplasms/secondary , Diagnosis, Differential , Fatal Outcome , Humans , Lung Neoplasms/pathology , Magnetic Resonance Imaging , Male , Stroke/diagnosis , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: The purpose of this article is to illustrate the spectrum of sonographic findings in perforated pyloroduodenal peptic ulcer and discuss the potential role of sonography in the diagnosis. CONCLUSION: Although sonography is not the first-line investigation of choice in suspected perforated peptic ulcer, understanding of the characteristic appearances seen during general abdominal sonography may aid the reader in the diagnosis of this important and sometimes overlooked cause of nonspecific abdominal pain. This may shorten time to the diagnosis and ultimate surgical management.
