Case 262

 We present a twenty-three-year-old female for epigastric pain. Approximately twenty days before, she felt pain at the lower abdomen below umbilicus when walking and constricting abdominal muscle. Four days before, she got a service of body massage, leading painful area moving from lower abdomen to epigastric area. The following day, slight fever emerged. The epigastric pain worsened, being hard to move. She was transported to the local emergence hospital, and got laboratory test and abdomen CT. However, they revealed no origin for abdominal pain. She was introduced to our hospital for further investigation. Laboratory test revealed white blood cells 8000/mm3, neutrophils 79%, CRP 0.79mg/dL, Chlamydia trachomatis IgA 7.66 μg/mL (< 0.9), IgG 17.7μg/mL (< 0.9). She agreed to take contrast-enhanced CT for further examination (Figs 1-4).

What is your imaging diagnosis ?

1.　Liver abscess

2.　Arterio-portal communication

3.　Liver hemangioma

4.　Fitz Hugh Curtis syndrome

answer

2022.4.4