Thursday, February 25, 2010

What is the Diagnosis?


How good of a diagnostician are you? This challenge from the New England Journal of Medicine is tough. (I missed it the first time).
Q: This 12 year old presented with decreased appetite and vomiting. What is the most likely diagnosis?
1. Endometrioma
2. Hernia
3. Keloid
4. Intraabdominal cancer
5. Urachal duct cyst.

Click on the image for a better view and make your guess. The answer will be posted tomorrow.

15 comments:

Anonymous said...

I think it is an umbilical hernia.

Raymond Bouchayer said...

I am pretty sure that it is #1,#2,#3,#4, or #5......but I'll say #3

Karen W. said...

This one is tough but I think it is #2

The Happy Hospitalist said...

I'm going with #5, the cyst. Deep in my medical school subconscious, I seem to remember some first year embryology regarding the urachal cyst being a remnant of something near the belly button.

So that's my answer.

Dang. That was 13 years ago.

Kellie said...

I'm guessing #5.

tracy said...

Going with # 5....and that was before i saw Happy's answer, i swear!

StorytellERdoc said...

I'm up for #5 too, although I've seen some gross keloids from the belly button rings...just don't be in any hurry to post a nipple keloid, okay? :)

ERP said...

Yeah, I go with 5. Although theoretically, it could be a cancer....

Toni Brayer, MD said...

Happy: Did you know you had so much influence? I see copy-cat happening here....answer to appear later

Kellie said...

I chose my guess of trying to decide between the cancer or cyst before clicking on the comment section, but after I saw the other comments figured it would look like copying.

The Happy Hospitalist said...

Doc. After I answered, I realized that the root of the word Urachal probably has something to do with the remnants of the bladder embryology (urology). And since those are pretty close to each other, I'm thinking it has to be that.

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