MediAI

Edited by ScholarGen MediAI Team Executive Clinical Summary A 90-year-old man presented with progressive bilateral leg edema for one month, accompanied by repeated episodes of malaise and dizziness associated with hypoglycemia. Physical examination revealed a nontender epigastric mass. The initial chest radiograph unexpectedly demonstrated a round, irregular opacity projected within the gastric chamber. An unusual colonic segment was also visible beneath the right hemidiaphragm. Subsequent upper gastrointestinal endoscopy revealed a large, extensively eroded exophytic mass in the subcardial region of the stomach. Histologic examination was consistent with high-grade poorly differentiated gastric adenocarcinoma . The patient was diagnosed with advanced gastric cancer and received palliative treatment. He died five months later. This case illustrates an important radiologic principle: an abnormality outside the primary field of interest may be the first imaging clue to a clinically signi...

Executive Clinical Summary Right lower quadrant pain is often approached as acute appendicitis, particularly when the clinical presentation suggests an acute inflammatory abdominal process. Yet the appendix is not always the source of inflammation. Terminal ileal diverticulitis is an uncommon cause of right lower quadrant pain that can closely mimic acute appendicitis. The diagnostic challenge arises from the close anatomical relationship between the terminal ileum, ileocecal valve, cecum, and appendix. The most important CT finding is not simply “right lower quadrant inflammation.” The critical question is: Where is the center of inflammation? In terminal ileal diverticulitis, the inflammatory focus is a diverticulum arising from the terminal ileum, usually near the ileocecal valve, with surrounding mesenteric fat stranding. In the present case, a 78-year-old woman presented with two days of right lower quadrant pain. Contrast-enhanced abdominal and pelvic CT demonstrated a smal...