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Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 1688563110.5144/0256-4947.2006.325asm-4-325What's Your Diagnosis?A 12-year-old boy with acute abdominal pain and distension Mohamed Ayadi Kamel Mariem Amouri Khaireddine ben Mahfoudh Sana Mezghani Ahmed Ahmedullah Mnif Jameledine From the Radiology Department, Habib Bourguiba Hospital, TunisiaCorrespondence and reprint requests: Ayadi Kamel Mohamed, MD, Radiology Department, Habib Bourguiba Hospital, 30 Algeria Avenue Sfax-Tunisia 3000, Tunisia, Tel: +216-9-897 2513, Fax: +216-7-424 3994, kamelayda@yahoo.comJul-Aug 2006 26 4 325 325 Copyright © 2006, Annals of Saudi Medicine2006This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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A 12-year-old boy was admitted for acute abdominal pain and distension. He reported similar episodes in the last two months, with spontaneous resolution. Physical examination revealed abdominal distension and no palpable mass. Multiple hyperpigmented round lesions were found around the mouth and in the buccal mucosa. Laboratory tests showed a moderate hypochromic microcytic anemia (9 g /dL). In light of these findings, an abdominal ultrasound scan (Figure 1) was followed by a barium meal and follow-through examination (Figure 2 and 3).

What is the diagnosis?

Answers on page 330.

Figure 1 Abdominal ultrasound scan, transverse cut.

Figures 2 and 3 Barium meal and follow-through examination.