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A 48-Year-Old Man Is Evaluated for Abdominal Pain and Diarrhea

Question 229

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A 48-year-old man is evaluated for abdominal pain and diarrhea.  The patient characterizes his stool as voluminous and foul smelling.  He has no significant past medical history.  The patient drinks 6 cans of beer daily.  On examination, he has normal bowel sounds and mild epigastric tenderness.  A 72-hour stool collection shows excessive excretion of fecal fat.  A CT scan of the abdomen is shown in the image below.  Involvement of which of the following structures is most likely causing this patient's symptoms? A 48-year-old man is evaluated for abdominal pain and diarrhea.  The patient characterizes his stool as voluminous and foul smelling.  He has no significant past medical history.  The patient drinks 6 cans of beer daily.  On examination, he has normal bowel sounds and mild epigastric tenderness.  A 72-hour stool collection shows excessive excretion of fecal fat.  A CT scan of the abdomen is shown in the image below.  Involvement of which of the following structures is most likely causing this patient's symptoms?   A) A B) B C) C D) D E) E


A) A
B) B
C) C
D) D
E) E

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